Malaria

Question 1

Clinical features

Answer 1

headache, malaise,
anorexia, Rigors, chills, sweating,
headache, abdominal pain, nausea
and vomiting

Other features include hemolytic
anemia, splenomegaly, jaundice
and hypoglycemia. Cerebral
malaria, renal failure, shock and
respiratory failure

Question 2

Features of severe malaria

Answer 2

(1)Cerebral malaria
2) Acute pulmonary edema and acute
respiratory distress
(3) Shock (‘Algid malaria’)
(4) Severe anemia <4g/dl
(5) Hyperpyrexia
(6) Hypoglycemia- <2mmol/L,
Failure to feed
(7) Metabolic acidosis- blood pH<
7.25, bicarbonate <15mEq/L, Deep
breathing, respiratory distress
(acidotic breathing)
(8) Acute renal failure, blackwater
fever
(9) Spontaneous bleeding and
coagulopathy
(10) Hyperparasitemia

Question 3

Investigations

Answer 3

Rapid diagnostic test
Malaria parasite smear (MPS)/ peripheral blood smear

Question 4

Differential diagnosis

Answer 4

 Typhoid fever
 Leptospirsosis
 Dengue
 Viral hepatitis