Two Cases Of Severe “Traveler’s Falciparum Malaria “ With Improved Conditions After Administration Of Quinine Oral Umar Zein Division of Tropical Diseases and Infections Department of Internal Medicine, School of Medicine, Sumatera Utara University Abstract : Traveler’s Malaria is a new emerging health problem in the whole world due to (1) the increasing mobility of international traveler and (2) The recurrent of the disease in the areas those once partially or fully freed from the disease. We are reporting 2 cases of severe ‘traveler’s malaria’ found attacked a man from Greece and a man from Philippine with the age of 54. Both of the patients are ship captains. On the first case found acute kidney failure with anuria and lung oedema, pneumonia and a progressive declining of haemoglobine concentration. With the second cases we found declining of consciousness, disorder of liver function with icterus, disorder of kidney function, bleeding of upper digestive tract, pneumonia and severe anemia, signs of DIC (Disseminated Intra-vascular Coagulation) and admission in ICU (Intensive Care Unit). Both of cases are assumed having resistance to Chloroquine and Fansidar. Both of them were treated with Quinine Sulphate by mouth (we hardly can find Quinine injection in Medan). With such treatment for a seven day duration we saw a significant clinical and laboratory improvement. The evidence were the disappearance of asexual parasite from peripheral blood. During the hospitalization both of the patien required PRC (blood) transfusion to overcome the tendency of progressive declining of haemoglobine. With the disappearance of parasite from blood, the disorder of the suffered organs mentioned above, gradually become normal. The condition of the patients showed a satisfactory improvement either. Keywords : Severe – Traveler’s Malaria – Complication – Quinine Sulphate (Acta Medica Indonesiana, Volume XXXIV, Number 3, July – September 2002) INTRODUCTION : The disease of malaria still creates problem both in developing and developed countries. This phenomenon is signed by still increasing number of incidence of the disease in recent time. The verdicts are assumed as 1 : 1. The increasing of malaria parasite resistance to the available chemotherapheutical medicines. 2. The increasing of Anopheles mosquito resistance to the currently used insecticides. 3. The significant change of climate and echo-system 4. The increasing number of international travelers e-USU Repository ©2004 Universitas Sumatera Utara 1