Lighting Learning: Malaria
““Malaria should be considered in any febrile or unwell patient who has visited endemic areas.””
What?
Infection with one of five Plasmodium species: falciparum, vivax, ovale, malariae, knowlesi
Initial symptoms are nonspecific:
Chills
Malaise
Fatigue
Sweating
Headache
Cough
Nausea
Vomiting
Abdominal pain
Diarrhoea
Arthralgia
Myalgia
Severe features:
Altered GCS/seizures
Respiratory distress or ARDS
Shock
Metabolic acidosis
Renal failure/heamoglobinuria
Hepatic failure
Coagulopathy +/- DIC
Severe anemia or massive intravascular haemolysis
Hypoglycemia
High parasite count
Why?
Malaria should be considered in any febrile or unwell patient who has visited endemic areas.
Most cases present within 3 months of return, but it can be longer.
Remember to ask a travel history that extends at least this far back!
Mortality (in the UK) is roughly 1%. A delay in recognition and treatment increases mortality and complications.
It is also important to consider other infections in anyone who has travelled and consider isolation until the diagnosis is confirmed.
Further Reading
- RCEM Learning: The Returned Traveler
- LITFL: Malaria
