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Table 5 Complications

From: Treatment outcome of intravenous artesunate in patients with severe malaria in the Netherlands and Belgium

Complication

Number of patients (%)

Recovery*

Haematological, n (%)

  

   Abnormal bleeding

1 (2)

Recovered

   Anemia

32 (47)

 

hemolytic†

7 (10)

Recovered in all

severe (Hb< 3.6 mmol/l)

2 (3)

Recovered in all

moderately severe (3.7 - 6.1 mmol/l)

23 (34)

Recovered in 11/11 ‡

   Thrombocytopenia (< 20 giga/L)

16 (24)

Recovered in all

   Hemoglobinuria

1 (2)

Recovered

Hepatobiliary, n (%)

  

   Elevated liver enzymes (LDH > 2x URL)

31 (46)

Recovery in 14/14‡

Renal, n (%)

  

   Acute renal insufficiency

7 (10)

Recovered in 5/5 ‡

   Acute tubular necrosis

1 (2)

Recovered

   Anuria

1 (2)

Not resolved, still in need of dialysis

   Elevated creatinine levels (> 20% above URL)

9 (13)

Recovered in 4/4‡

Nervous system, n (%)

  

   Anal sphincter dysfunction

1 (2)

Recovered

   Aphasia

1 (2)

Recovered

   Cerebral edema

1 (2)

Recovered

   Coma

2 (3)

Recovered

   Convulsion

3 (4)

Recovered

   Delirium

2 (3)

Recovered in 1/2 §

   Diplopia

1 (2)

Restoring but lost to follow up

   Neurological deficit

1 (2)

Recovered

Truncal ataxia

1 (2)

Restoring but lost to follow up

Cardiovascular, n (%

  

   Arterial hypertension

1 (2)

Recovered

   Atrial flutter

2 (3)

Recovered

   AV Block (1st degree)

1 (2)

Recovered

   Prolonged QTc interval

1 (2)

Recovered

   Sinus bradycardia

1 (2)

Recoveredâ•‘

   Supraventricular tachycardia

1 (2)

Recovered

   Thrombophlebitis

2 (3)

Recovered

Respiratory, n (%)

  

   Exercise induced dyspnea

1 (2)

Recovered

   Pneumonia

4 (6)

Recovered

   Respiratory insufficiency

4 (6)

Recovered

Other, n (%)

  

   Deafness

3 (4)

Recovered in 2/3¶

   Diarrhoea

3 (4)

Recovered

   Fever

1 (2)

Recovered

   Furunculosis

1 (2)

Recovered

   Hypoglycaemia

1 (2)

Recovered

   Peri-anal abcess

1 (2)

Recovered

   Rash

2 (3)

Recovered

   Reactive arthritis

1 (2)

Recovered

   Sepsis

1 (2)

Recovered

   Tropical ulcers

1 (2)

Recovered

  1. URL: Upper reference limit reported by laboratory of admitting hospital
  2. * Number of patients that completely recovered/number of patients of whom data was complete (adequate follow up)
  3. † characterized by increased reticulocyte counts, unconjugated bilirubin and lactate dehydrogenase and decreased haptoglobin and haemoglobin (Hb) values. See Table 6 for further details
  4. ‡ complication restoring in the remaining patients but patients were not followed until complete recovery (incomplete data)
  5. § the other patient died
  6. â•‘ patient received pacemaker
  7. ¶right ear remains deaf in one patient
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Malaria Journal

ISSN: 1475-2875

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