Malaria Treatment case discussion
Symptoms
30 year old patient presented to clinic. He had complaint of fever, feeling cold and shivering since few days. He noticed yellowish discoloration of eyes and urine since 2 days. Also had fatigue, nausea, loss of appetite and myalgia. He was working in malaria endemic area.
On examination GCS 15/15. BP- 116/78, pulse-138 BPM, SPO2- 99%. Bilirubin total 2.6, HB- 13.4, WBC- 4200. Platelet count 63,000 (normal more than 1,50,000) so that was low. Plasmodium Falciparum (malaria protozoa) was positive. No G6PD deficiency noted.
So diagnosed with FALCIPARUM MALARIA.
Malaria Treatment
He was not willing to get admitted so started treatment in Clinic. Given I/V ARTESUNATE 120 mg BD on day 1, then 120mg od for 4 days, C. DOXYCYCLIN 100 mg BD, PRIMAQUINE 45 mg stat, URSODEOXYCHOLIC ACID 300 mg bd, SILYMARIN 140 mg BD and supportive care.
He was better after 4 hours. And asymptomatic on 2nd day. Platelet count on day 2 was- 72000. day 3 it was- 1,20,000. day 4 it was- 1,60,000. Doing well now. Saved another life at very low cost.
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DR RAKESH UKEY, MD