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Acute kidney injury secondary to severe delayed haemolysis in intravenous artesunate use for severe malaria
  1. Kai Wen Leong1,
  2. Kasha P Singh2,3,
  3. Karin Leder2,4 and
  4. Steven Y C Tong2,3
  1. 1Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia
  2. 2Victorian Infectious Diseases Service, Royal Melbourne Hospital, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
  3. 3Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
  4. 4Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
  1. Correspondence to Dr Steven Y C Tong; steven.tong{at}


The use of artemisinin derivatives has been recommended by the WHO guidelines in malaria treatment largely due to its rapid parasite clearance and safety profile. This case report details the development of delayed haemolysis and subsequent severe acute kidney injury (AKI) 13 days after commencing intravenous artesunate treatment for malaria in an Australian returned traveller. Delayed haemolysis may be an under-recognised complication following artesunate use and if severe, can be complicated by AKI. Therefore, close patient follow-up following treatment is required to ensure prompt recognition of this phenomenon.

  • drugs: infectious diseases
  • tropical medicine (infectious disease)
  • acute renal failure
  • haematology (incl blood transfusion)

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  • Contributors KL and KPS were involved in the care of the patient. The manuscript was drafted by KWL. The manuscript was reviewed and revised by all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.