Severe falciparum malaria with hyperparasitaemia: management without exchange blood transfusion.

The risk of complication in falciparum malaria is associated with parasite load. Drug therapy alone may be insufficient, and blood exchange transfusion is indicated when more than 10% of erythrocytes are parasitized with concurrent pulmonary, renal, cerebral or haemostatic complications; without complications, when the parasitized erythrocytes exceed 30%. The successful use of conventional malaria therapy without exchange transfusion in a young woman with severe falciparum malaria is reported.