🚨 Chapter 334 · Malaria — Severe Malaria Treatment & Supportive Care

Nelson Textbook of Pediatrics 22nd Edition | Severe malaria (primarily P. falciparum) is a medical emergency with high mortality. WHO criteria: cerebral malaria (coma), seizures, severe anemia (Hb <5 g/dL), acidosis, hypoglycemia, renal failure, ARDS, shock, hyperparasitemia (>10%). Treatment: IV artesunate (first-line) for at least 3 doses, followed by oral ACT. Supportive care: aggressive glucose monitoring, seizure control, careful fluid management, blood transfusion for severe anemia. Exchange transfusion is not routinely recommended. Prompt recognition and ICU care save lives.