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P. knowlesi Malaria — SCE Infectious Diseases MCQ

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HardTropical & Imported InfectionsP. knowlesi MalariaSCE Infectious Diseases

A 38-year-old man presents with Plasmodium knowlesi malaria after travel to Malaysian Borneo. His parasitaemia is 8% with no other severity features. What is unique about P. knowlesi that makes this a potentially dangerous infection?

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Correct answer: A — P. knowlesi has a 24-hour erythrocytic cycle, allowing rapid escalation of parasitaemia

Plasmodium knowlesi (a zoonotic malaria parasite with macaque monkey reservoir, endemic to South-East Asia) has a uniquely short 24-hour erythrocytic replication cycle (compared to 48 hours for P. falciparum and P. vivax). This means parasitaemia can double daily, with rapid progression to hyperparasitaemia and severe disease. P. knowlesi can be misidentified as P. malariae on blood film due to morphological similarity. Treatment follows P. falciparum guidelines (ACT for uncomplicated; IV Artesunate for severe).

Reference: WHO 2022 – Malaria guidelines; UKHSA 2023 – P. knowlesi