A 30-year-old man returns to the clinic with fever, chills, and headache five days after returning from a backpacking trip to sub-Saharan Africa. He complains of muscle aches, mild nausea, and occasional sweating spells, but no cough or rash. He took antimalarial medication inconsistently during the trip.
On examination:
- Temp: 102.4°F (39.1°C)
- Pulse: 110 bpm
- Mild pallor, no jaundice, no lymphadenopathy
- Abdomen: Mild splenomegaly
- Neurologically intact
Labs:
- Hb: 10.2 g/dL
- WBC: Normal
- Platelets: 90,000
- Mildly elevated bilirubin
- Rapid diagnostic test: Positive for Plasmodium falciparum
What’s your immediate management plan for this patient? How does P. falciparum differ from other malaria species in terms of severity and treatment? What are the red flags for severe malaria?