Multidrug Resistant Transfusion Vivax Malaria

Emiliana Tjitra; Bondan Lukito; Suriadi Gunawan

doi:10.14238/pi34.5-6.1994.175-8

Emiliana Tjitra Communicable Diseases Research Centre, National Institute of Health Research and Development, Ministry Of Health, Jakarta
Bondan Lukito Graha Medica Hospital and Elizabeth Clinic, Jakarta
Suriadi Gunawan Communicable Diseases Research Centre, National Institute of Health Research and Development, Ministry Of Health, Jakarta

DOI: https://doi.org/10.14238/pi34.5-6.1994.175-8

Keywords: multidrug resistant transfusion; vivax malaria; exchange transfusion; hyperbilirubinemia

Abstract

A 17-day-old premature baby girl had received a blood exchange transfusion because of hyperbilirubinemia and got another blood transfusion because of severe anemia on day 45. The diagnosis of transfusion vivax malaria was made when she had severe anemia again on day 78. The most predominant clinical signs were fever, anemia, hepatosplenomegaly, and thrombocytopenia. Treatment with chloroquine 25 mg base/kg BW showed resistance at RIII level on a 7 -day follow up. She was retreated. with quinine 10 mg salt/age in month divided in 3 doses/day for 7 days. lt also showed resistance at late RI level on day-30. Then she was retreated with quinine 15 mg salt/age in month divided in 3 doses/day for 7 days and still showed resistance at late Rl level on day 32. Finally she was treated with quinine 10 mg salt/kg BW /dose, tid for 7 days which was effective. During the course of treatment, no adverse reactions were found clinically. This malaria case was transfusion vivax malaria resistant to choloroquine at R III level and to quinine at late RI level. Quinine 10 mg salt/BW I dose tid for 7 days was effective and safe for infants.

References

1. Bruce-Chwatt. Transfusion malaria. Bull WHO 1974; 50:337-46.
2. Rustam M. Menuju pelayanan darah yang bermutu. Lokakarya upaya transfusi darah, Februari 13-15, 1992, Bogor.
3. Pribadi W, Ismid IS, Dakung LS, Sri Oemijati. Suspected transfusion malaria in Jakarta. Maj Kedok Indones 1976; 9-10: 1050-5.
4. Wiguno D, Santoso SSI, Zainul A, Akbar N, Sumarsono. Accidental malaria after blood transfusion: Report of 3 cases with a literature study. Acta Medica Indonesia 1974; 5:100-3.
5. Lumanauw FH, Kosasih EN, Depary AA, Lubis RM. Beberapa kasus dengan sangkaan malaria pasca transfusi darah. Buletin Transfusi Darah 1978; 55:25-8.
6. World Health Organization. The clinical management of acute malaria. WHO Regional Office for South-East Asia, New Delhi, 1990:39-69.
7. Departemen Kesehatan Republik Indonesia. Direktorat Jendral PPM & PLP. Malaria: Pengobatan 3, 1991:46-54.
8. Boyd MF. Epidemiology of malaria. In: Boyd MF ed. Malariology. Philadelphia: Saunders, 1949; 1:551-608.
9. Schwartz IK, Lackritz EM, Patchen LC. Letter : Chloroquine resistant Plasmodium vivax from Indonesia. New Engl J Med 1991; 324:927.
10. Baird JK, Basri H, Purnomo, et al Resistance to chloroquine by Plasmodium vivax in Irian Jaya, Indonesia. Am J Trop Med Hyg 1991; 44:547-52.
11. Murphy GS, Basri H, Purnomo, et al. Vivax malaria resistant to treatment and prophylaxis with chloroquine. Lancet 1993; 341 :96-1 00.
12. Chongsuphajaisiddhi T. Childhood malaria : Treatment Simposium on tropical and parasite diseases. Tarumanagara University, Jakarta, August4, 1990.
13. Bruce-Chwatt et al. Preventive Use of Antimalarial Drugs. In Chemotherapy of Malarial. 2nd ed. WHO Monograph Series, Geneva, 1986; 27: 164.
14. Marshaal H. Blood Transfusion malaria. In: Clinical malariology. SA Medical Information Center. International Medical Foundation of Japan, 1986: 272-82.