Symptoms of severe Malaria
（1）Shock：if the patients'limbs are cold，systolic blood pressure＜50 mm Hg in children who are 1～5 years old or systolic blood pressure＜80 mm Hg in children are more than five years old.
（2）Altered：consciousness and/or convulsions.In a comatose patient，convulsions（seizures）may be subtle.i.e.minor movements or unusual repetitive movements.
（3）Severe anaemia：All patients with PCV＜12%or HB＜4g/d L should be transfused.Use packed red cells in most cases；in shock or severe acidosis，use whole blood.The volume transfused should be 20 mL/kg.
（4）Metabolic acidosis（deep，fast breathing）：exclude or treat hypoglycemia，hypovolaemia and gram negative septicaemia.(https://www.daowen.com)
（5）Spontaneous bleeding or coagulopathy：
（6）Acute pulmonary oedema in adults：prevent by avoiding excessive rehydration.
（7）Acute renal failure in adults：detect this by monitoring fluid balance carefully.Identify and correct any dehydration or hypovolaemia.Maintain strict fluid balance.Consider peritoneal dialysis if oliguria persists beyond a few days.
（8）Common infections and other condition that present like severe malaria：Perform urinalysis，lumbar puncture（unless contraindicated），blood culture if possible，and chest X-ray.