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BACKGROUND Approximately 6% of children hospitalised with severe falciparum malaria in Africa are also bacteremic. It is therefore recommended that all children with severe malaria should receive broad spectrum antibiotics in addition to parenteral artesunate. Empirical antibiotics are not recommended currently for adults with severe malaria. METHODS Blood cultures were performed on sequential prospectively studied adult patients with strictly defined severe falciparum malaria admitted to a single referral centre in Vietnam between 1991