From the Guidelines
Sepsis caused by malaria can lead to anemia, particularly in cases of severe malaria where hemoglobin levels may drop below 6 g/dL, necessitating blood transfusion. According to the study published in Intensive Care Medicine in 2012 1, malaria-induced sepsis is a significant cause of anemia, and the management of such cases involves the prompt initiation of antimalarial treatment, such as parenteral artesunate, alongside careful fluid management and consideration of blood transfusion in severe anemia. Key points to consider in the management of malaria-induced sepsis include:
- Prompt start of parenteral artesunate in adults and children
- Consideration of blood transfusion in cases of severe anemia (hemoglobin level < 6 g/dL) 1
- Judicious fluid management to avoid overhydration
- Empirical antibiotic therapy to cover Gram-positive, Gram-negative, and anaerobic bacteria 1 It is essential to note that the severity of anemia often correlates with the severity of the sepsis, and timely intervention is crucial to prevent morbidity and mortality. In clinical practice, it is vital to prioritize the management of the underlying infection while providing supportive care to address anemia and other complications of sepsis.
From the FDA Drug Label
Systemic adverse events that were reported with meropenem for injection occurring in greater than 1.0% of the patients were ... sepsis (1.6%), ... Hemic/Lymphatic:anemia, hypochromic anemia, hypervolemia The most common adverse events occurring in greater than 5% of the patients were: ... anemia (5.5%)
Sepsis can cause anemia.
- Sepsis is reported as a systemic adverse event in patients treated with meropenem for injection.
- Anemia is also reported as a hemic/lymphatic adverse event in these patients.
- Additionally, anemia is one of the most common adverse events in patients with complicated skin and skin structure infections treated with meropenem for injection 2.
From the Research
Types of Sepsis that can Cause Anemia
- Sepsis induced by hemolytic pathogens can cause anemia, as it leads to the destruction of red blood cells 3
- Malaria, a type of sepsis caused by Plasmodium parasites, can lead to anemia due to increased removal of circulating erythrocytes and decreased production of erythrocytes in the bone marrow 4, 5, 6
- Severe malarial anemia, caused by Plasmodium falciparum, is a significant contributor to morbidity and mortality in endemic areas 5
Mechanisms of Anemia in Sepsis
- Ineffective erythropoiesis, where the bone marrow fails to produce adequate red blood cells, is a key mechanism of anemia in malaria-induced sepsis 4, 6
- Suppressed proliferation, differentiation, and maturation of erythroid precursors can lead to insufficient erythropoiesis during malaria 6
- Hemolysis, or the destruction of red blood cells, can occur due to various triggers, including transfusion reactions, complement activation, and disseminated intravascular coagulation 3