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Saving child with malignant cerebral malaria thanks to rapid response at IMC
Published in The Saudi Gazette on 19 - 05 - 2022

An 11-year-old girl has arrived to the emergency department at the International Medical Center in a state of delirium, malaise, dizziness and severe body ache.
Upon her arrival at the emergency room, she has received all the necessarily medical interventions to stabilize her clinical condition. Shortly, she was admitted to the pediatric department as a case of suspected sepsis for further management.
A few hours later, she has developed signs and symptoms of septic shock, assessed by pediatrics rapid response team and transferred to the Pediatric Intensive Care (PICU) to commence the septic shock management bundle in a timely fashion.
Shortly thereafter the patient was diagnosed as a case of malignant cerebral malaria with multiple organ failure, based on clinical assessment, cerebral spinal fluid examination together with magnetic resonance imaging MRI and specific malaria film, which indicate the diagnosis of plasmodium falciparum rare type of malaria.
Cerebral malaria is an acute encephalopathy caused by the malaria parasite Plasmodium falciparum, which develops in a small minority of infected patients and is responsible for the majority of deaths and long-term complications in the affected child.
In addition to the general intensive care management and support, this type of malaria require a special category of anti-malaria medication which is usually difficult to provide in an ordinary way and timely manner, that led to a quick action by the head of the pharmacy Dr. Ali Saber who made sure this medication available in a record time.
Within 48 hours of PCIU admission and receiving all necessarily interventions together with the anti-malaria medication, the patient has shown dramatic improvement and quick recovery. She has regained her conscious level and all of neurological functions without any further complications.
The rapid response and PICU team was led by Dr.Rafat Mosali, the head of the Pediatric intensive care unit, Dr.Iyad Al-Sarhi, Pediatric Intensive Care Consultant, Dr.Nawaf Al-Daajani, Consultant Pediatric Infectious Diseases, and Dr.Mahmoud Youssef, Pediatric Intensive Care Specialist.
After few days, patient was moved to the general pediatric ward to continue her appropriate oral medications as advised by pediatric infectious disease team. Patient was discharged home thereafter in a full stable and healthy condition.


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