CEREBRAL MALARIA ON CHILDREN IN ENDEMIC AND REMOTE AREA, DISTRICT 0F YAHUKIMO, PAPUA
Ikatan Dokter Indonesia
Background : Cerebral malaria is a dangerous complication of malaria. Symptoms are marked by a decrease in consciousness and often accompanied by seizures. Cerebral malaria often occurs to children between the ages of 6 months to 3 years.
Case Presentation Summary : A 2-year-old girl with good nutritional status came with a high fever that has already lasted for a week. She had 3 seizures at home. But, no history of previous seizure. Vital sign: temperature 38oC with normal heart rate and respiration rate, awareness: somnolent. Physical examination of lung and heart normal. The heart and lien are not palpated. Normal limb. Microscopic examination of DDR positive malaria falciparum (++), Hb: 6gr%. Patients were diagnosed with Cerebral Malaria. Artesunate Injection Therapy 30 mg (0.12, 24 hours) continued with the same dosage every 24 hours for 4 days. Diazepam injection 3.75 mg during seizures and phenytoin 62,5 mg /12 hours. Paracetamol drips 125 mg /8 hours when body temperature over 38o C. Installed NGT and urine catheter. On the fifth day, patient was fully awake and there was no signs of fever. Her condition was improved and could started to eat. The therapy was continued by oral DHP 1 tablet daily for 3 days, Primaquin ¼ tablets daily for 1 day, and sangobion syrup 1 x 5 ml per day. On the sixth day, the patient was allowed to go home.
Learning Points/Discussion : Cerebral malaria in children accompanied by seizures and anemia improved on fifth day after the treatment with artesunate and phenytoin. The therapy was continued orally with DHP, primaquine and sangobion. The patient went home on the sixth day and the post-hospital control showed a good result. Enforcement of the diagnosis of cerebral malaria and appropriate therapy will prevent more severe complications on children, in endemic and remote areas.
Keywords: CEREBRAL MALARIA ON CHILDREN MALARIA IN ENDEMIC AND REMOTE AREA DISTRICT OF YAHUKIMO MEIVITA TAHALELE
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