Abstract
Malaria remains an overwhelming problem with around 214 million cases reported worldwide
each year. It remains a major health problem in the tropical developing countries
and India accounts for 70% of the total malaria incidence in the Southeast Asia region.
Even though, artesunate, a novel drug used in the treatment of chloroquine-resistant
cases of Plasmodium falciparum infection causes transient transaminitis (elevation of alanine and aspartate transaminases),
hepatitis and hepatic encephalopathy are very rare. We encountered a child with falciparum
malaria, who accidently ingested artesunate tablets (16 mg/kg) and developed hepatic
encephalopathy with clinical and biochemical improvement in a matter of 4 to 5 days.
There are only a few reports of children with malaria developing hepatic encephalopathy,
with or without coinfection with hepatotropic viruses. Also, there are no reports
of hepatic encephalopathy secondary to artesunate overdose, creating a dilemma in
diagnosis and management.
Keywords
malaria - hepatic encephalopathy - artesunate - children
