Kramer S L, Campbell C C, Moncrieff R E
JAMA. 1983 Jan 14;249(2):244-5. doi: 10.1001/jama.1983.03330260062034.
A 48-year-old physician, who was not undergoing malaria chemoprophylaxis, contracted Plasmodium falciparum while working in eastern Thailand. In the hospital, he had a peak parasitemia of 72% RBCs infected, associated with CNS dysfunction. As an adjunct to chemotherapy, a double-volume whole-blood exchange transfusion was performed on the first hospital day, dropping the parasitemia to less than 1% within 32 hours. The patient's clinical condition improved, with a prompt reversal of CNS, hepatic, and renal complications. These results, combined with those in previously reported cases, suggest that exchange transfusion should be considered more generally as a life-saving procedure in P falciparum infections.
一名48岁的医生，未进行疟疾预防性化疗，在泰国东部工作时感染了恶性疟原虫。在医院里，他的最高寄生虫血症为72%的红细胞被感染，并伴有中枢神经系统功能障碍。作为化疗的辅助手段，在入院第一天进行了双倍量全血置换输血，在32小时内将寄生虫血症降至1%以下。患者的临床状况有所改善，中枢神经系统、肝脏和肾脏并发症迅速得到缓解。这些结果，结合先前报道病例的结果，表明在恶性疟原虫感染中，全血置换输血应更普遍地被视为一种挽救生命的程序。
