Malaria can worsen after initial good presentation

Patients with malaria caused by Plasmodium falciparum can develop severe complications even though they seem well at initial presentation. Moore and colleagues (p 808) present two cases where patients' conditions deteriorated sharply despite treatment. They recommend clinicians consider three points. Firstly, severe malaria can occur with low parasitaemia since the peripheral load may not reflect the total parasite load. Secondly, normal investigations at presentation do not exclude the risk of later complications. Thirdly, the assumption that people native to endemic regions are immune to the disease is not always correct.

(Credit: CNRI/SPL)

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Relevant Article

Lesson of the week: Assessing the severity of malaria

David A J Moore, Richard M Jennings, Tom F Doherty, Diana N Lockwood, Peter L Chiodini, Stephen G Wright, and Christopher J M Whitty
BMJ 2003 326: 808-809. [Extract] [Full Text] [PDF]