Other features

• Beware of modified infection.

• Typical relapsing patterns often absent.

• Thick smear allows detection of parasites (some laboratories are poorly skilled with thick films).

• Thin smear helps diagnose malaria type.

Typjcal features

Other poss<bäe features headache malaise fiever/chiîls prost ration sweating myalgia r p un R k h 1 H , H ■

hepatomegaly]

cental pm&lents

• convulsions

• coma anaemia jaundice vtimitsng poshura! hypotension cough splenomegaly pair duorrtiûea drrfiythsnia r p un R k h 1 H , H ■

hepatomegaly]

cough splenomegaly pair duorrtiûea drrfiythsnia dark urine (blatkwater fever)

Fig. 12.2 Clinical features of malaria dark urine (blatkwater fever)

Fig. 12.2 Clinical features of malaria

If index of suspicion high, repeat the smear ('No evidence of malaria' = 3 negative daily thick films). Monocytosis is a helpful diagnostic clue. Newer tests e.g. PCR tests and ICT card tests show promise. Cerebral malaria and blackwater fever are severe and dramatic.

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