MONITORING OF INTRAVENOUS QUINIDINE INFUSION IN THE TREATMENT OF PLASMODIUM-FALCIPARUM MALARIA

OBJECTIVE: TO report a case of Plasmodium falciparum malaria in which intravenous quinidine was used, resulting in a prolonged QT interval. CASE SUMMARY: P.falciparum malaria was diagnosed in a woman visiting f rom Nigeria. Treatment was instituted with intravenous quinidine given the high level of parasitemia. During the quinidine infusion, the pat ient experienced a prolonged QT interval and an episode of supraventri cular tachycardia. The infusion rate was decreased and the QT duration returned to normal; there was no further episode of arrhythmia. Subse quently the patient was given oral quinine. Her condition improved and she was discharged on day 4 of therapy. DISCUSSION: P.falciparum mala ria, not commonly seen in the US, is associated with severe morbidity and mortality. This condition necessitates prompt treatment with intra venous quinidine, which can be associated with toxicity. The use of th is agent to treat malaria is reviewed herein. CONCLUSIONS: In patients with P.falciparum malaria, a high-level parasitemia may require treat ment with a potentially toxic agent, intravenous quinidine. Cardiac mo nitoring of these patients is essential during such therapy.