2nd August 2023

A 38 year old man presents with a progressive week-long history of fevers, fatigue, muscle ache and palpitations.

A 38 year old man presents with a progressive week-long history of fevers, fatigue, muscle ache and palpitations. Today, he has started passing “black” urine, prompting him to seek medical advice. He recently returned from a trip to Somalia but has no significant past medical history.

His temperature is measured at 39.2ᵒC. On palpation, his abdomen is generally tender but soft, with no guarding. On blood tests, he has severe metabolic acidosis, a stage 3 AKI, and has gone into DIC. Microscopy of a blood film shows Plasmodium falciparum, with a parasitaemia of 12%. Treatment with IV artesunate has been commenced.

What additional therapy might be considered?

Select the SINGLE most appropriate option from the list below. Select ONE option only.