Tropical

Severe Malaria (WHO)

Counts WHO criteria for severe malaria in a patient with confirmed parasitemia. Any single criterion mandates parenteral artesunate and high-acuity care.

Impaired consciousness (GCS < 11) or unrousable coma

≥ 2 generalized convulsions in 24 hours

Prostration (unable to sit, stand, or feed without assistance)

Respiratory distress (acidotic breathing)

Circulatory collapse / shock (SBP < 80 adult, < 70 child)

Significant bleeding / DIC

Jaundice (bilirubin > 3 mg/dL or 50 µmol/L)

Hyperparasitemia (P. falciparum > 10%)

Hypoglycemia (< 40 mg/dL or 2.2 mmol/L)

Severe anemia (Hb < 5 g/dL adult, < 7 g/dL child)

Renal impairment (creatinine > 3 mg/dL / 265 µmol/L OR urea > 20 mmol/L)

Acidosis (HCO₃ < 15 mmol/L or lactate > 5)

Pulmonary edema (radiological or SpO₂ < 92% on room air)

Source

World Health Organization. Severe Malaria. Tropical Medicine & International Health 2014.

PMID 25214480 Ask House about this