Reduced splenic function can mimic artemisinin resistance in severe malaria.

Camille Roussel, Alexandra Serris, Benoît Henry, Barthelemy Lafon Desmurs, Emilie Sitterlé, Marie Elisabeth Bougnoux, Nicolas Argy, Sébastien Larréché, Mariane De Montalembert, Vincent Ioos, Ilhame Tantaoui, Charlotte Chambrion, Aurélie Fricot, Claire Rouzaud, Fanny Lanternier, Olivier Lortholary, Sandrine Houzé, Stéphane Jauréguiberry, Marc Thellier, Papa Alioune Ndour, Pierre Buffet

Journal of Travel Medicine 2023 November 14

We describe severe post-treatment episodes that complicate Plasmodium falciparum malaria in patients with hyposplenism, characterized by prolonged circulation of red cells containing dead parasites (hearse red cells), persistent or recurrent fever, profound anaemia, and inflammation. Asplenia-related Post-antimalarial Inflammation & Hemolysis (APIH) mimics concomitant infection and parasite resistance to drugs.

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