Abstract
Although malaria is no longer endemic in Canada, it remains an important imported disease, principally among immigrants and travellers. The role of exchange transfusion in malaria treatment, in addition to standard anti-malarial treatment, remains controversial and is not well established. We report a case of severe malaria in a male traveller, complicated by multiorgan failure, septic shock, myositis, and unusual Streptococcus pneumoniae bacteremia. Manual exchange transfusion was used, in addition to artesunate-based therapy, and the patient responded well. This report shows that malaria remains an important differential diagnosis for travellers returning with fever and emphasizes the importance of prompt diagnosis and appropriate treatment.
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