Exchange transfusion in a case of severe Plasmodium falciparum infection: a case report.

A 45-year-old Canadian man, who had recently returned from Cameroon, complained of fever lasting eight days. He had 40% parasitemia with Plasmodium falciparum. In spite of oral therapy with chloroquine, quinine, and tetracycline, the patient's condition deteriorated. Although his clinical condition improved more slowly, the patient's parasitemia improved considerably after exchange transfusion and the institution of parenteral quinidine therapy. Exchange transfusion may be life-saving in falciparum malaria and should be instituted early in severe cases.