We report on a five month-old infant from Cameroon, who was admitted becaus
e of febrile gastroenteritis after living in Germany for two weeks. Since t
he patient was somnolent, had a parasitaemia of Plasmodium falciparum of 23
0 000/mu l, a haemoglobin concentration of 5.3 g/dl and a thrombocytopenia,
a complicated falciparum malaria was diagnosed. Treatment was started imme
diatedly with intravenous 20 mg quinine/kg bw as a loading dose, followed b
y 10 mg/kg bw every 12 hours, combined with intravenous clindamycin 10 mg/k
g bw bd. Red blood cells were transfused once. The parasitaemia dropped to
2000 trophozoites/mu l within 48 hours. No asexual stages were detectable f
rom the third day of treatment on. Weekly controls for the following four w
eeks remained negative. The mortality rate of complicated malaria is 50% in
the first year of life, which can be reduced by early treatment. We presen
t this case to draw attention to therapeutic options in infants.