• S Markoff, S Wilk-Vollmann, B Foroutan, and C Borchardt.
• Klinik für Anästhesiologie, Intensivmedizin, Schmerztherapie und Rettungsdienst, Bundeswehrkrankenhaus Berlin, Scharnhorststraße 13, 10115, Berlin, Deutschland. stefanmarkoff@bundeswehr.org.
• Anaesthesist. 2019 Oct 1; 68 (10): 683-688.

AbstractThis article reports the course of a complicated malaria in a 41-year-old male patient. After spending several months in Mali, the patient decompensated shortly after onset of the first symptoms. Under the signs of a multi-organ failure and with an initial parasitic load of 25%, the patient developed a microcirculation disturbance in the acra. In addition to sepsis-induced disseminated microthrombosis, high-dose catecholamine treatment contributes to the genesis of this disease with a high clinical probability. To improve the peripheral blood circulation, intravenous treatment with the synthetic prostaglandin E1 (PGE1) alprostadil with 20 μg (1-0-1) was carried out over a period of 21 days. Relevant circulatory depression as a side effect did not occur. The microcirculatory disturbances were no longer evident and the necrosis healed. Furthermore, the clearance course of the plasmodia was delayed under artemisinin-based combination therapy. Prolonged hemolysis required multiple transfusions.

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