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Traveler's Malaria is a new emerging health problem in the whole world due to (I) increasing inability of international travelers and (2) recurrence of diseases in areas that was once, partially or fully freed from the disease.We report 2 cases of severe traveler's malaria found in a man from Greece and a man from the Philippines aged 54 tears. Both patients were ship captains. They have stayed in Kenya prior to the catching the disease. In the first case, we found acute kidney failure with anuria and lung edema, pneumonia, and a progressive decline in hemoglobin concentration. In the second cases we found reduced consciousness, disorder of liver function with jaundice, disorder of kidney function, bleeding from the upper digestive tract, pneumonia, severe anemia, and signs of DIC (Disseminated Intra-va.icttlar Coagulation). The second patient was admitted to the ICU( Intensive Care Unit). Peripheral blood smears found ring forms and growing Plasmodiumfalc.iparum trophozoits. Both cases were assumed to be resistant to Chloroquine and Fansidar. Both of them were treated with oral Quinine Sulphate {we could hardly find Quinine injection in Medan), With such treatment for seven days, we found significant clinical and laboratory improvements. Asexual parasites were no longer found in the peripheral blood smear. During the hospitalization, both patients required Packed Red Cell (blood) transfusion to overcome the progressive drop in hemoglobin level. With the disappearance of the parasites from the patients' blood, the disorders of the organs mentioned above, gradually became normal. The conditions of the patients also showed satisfactory improvement. |
