SHM Converge Scientific Abstract ePoster Gallery-The Bug Then the Drug: Post-Artemisinin Hemolysis in a Toddler

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This text describes a case of <strong>post-artemisinin delayed hemolysis (PADH)</strong>, an uncommon complication after treatment of severe <strong>Plasmodium falciparum</strong> malaria with artesunate.

The patient had abdominal distension, mild tenderness, and mucosal pallor, but normal vital signs. Although his peripheral smears no longer showed malaria parasites or other organisms, he developed significant anemia after treatment. He required <strong>three red blood cell transfusions</strong>, with hemoglobin improving from a low level to <strong>8.1 g/dL</strong> before discharge. Based on the timing and lab course, clinicians concluded he was experiencing <strong>PADH</strong> rather than persistent infection.

PADH is known to occur after artesunate therapy and is seen more often in <strong>endemic settings</strong> or among <strong>non-immune travelers</strong> with severe falciparum malaria. The discussion notes that clinicians are exploring better ways to estimate risk, including using <strong>parasite density on peripheral smear before treatment</strong>, which may be more practical than flow cytometry in some settings.

The patient was discharged with close hematology follow-up. The references support the idea that PADH is a recognized, predictable complication related to the rapid parasite clearance effect of artemisinin-based treatment.

Asset Subtitle

Carleigh Rand

Meta Tag

Author List Carleigh Rand

Category Clinical Vignettes

Concept Post-Artesunate Delayed Hemolysis

Concept Artesunate

Concept Severe Falciparum Malaria

Concept Non-immune Patient

Concept Anemia

Distinguished Non-Finalist

Presenter Organization University of Minnesota

Presenting Author Carleigh Rand

Track Pediatric

Keywords

post-artemisinin delayed hemolysis

PADH

artesunate

Plasmodium falciparum

severe malaria

anemia

red blood cell transfusion

parasite density

non-immune travelers

hematology follow-up

Post-Artesunate Delayed Hemolysis

Artesunate

Severe Falciparum Malaria

Non-immune Patient

Anemia