An asplenic adult returns from New England with fever, jaundice, thrombocytopenia and intravascular haemolysis. Blood film shows intraerythrocytic rin...

Question

An asplenic adult returns from New England with fever, jaundice, thrombocytopenia and intravascular haemolysis. Blood film shows intraerythrocytic ring forms and Maltese-cross tetrads; parasitaemia is 14%, with hypoxaemia and acute kidney injury. In addition to urgent antimicrobial therapy, which adjunct should be considered?

Accepted Answer

Perform urgent red-cell exchange with haematology and infection specialists

Answer

Perform therapeutic plasma exchange to remove circulating inflammatory mediators

Answer

Give simple red-cell transfusion while continuing specific antimicrobial therapy

Answer

Give intravenous artesunate while awaiting definitive parasite speciation

Answer

Use isovolaemic venesection with crystalloid replacement to reduce viscosity

Lifestyle BP Management — MRCP Part 1 MCQ