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Uncomplicated Falciparum — SCE Infectious Diseases MCQ

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EasyTropical & Imported InfectionsUncomplicated FalciparumSCE Infectious Diseases

A 45-year-old man develops an acute febrile illness with petechial rash 2 days after returning from the Congo Basin. Thick blood film shows P. falciparum with parasitaemia of 0.5%. He is alert, haemodynamically stable, and able to eat and drink. Glucose, renal function, and lactate are normal. What is the most appropriate treatment?

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Correct answer: B — Oral Artemether/Lumefantrine (Riamet) — standard dose over 3 days

This is uncomplicated P. falciparum malaria (parasitaemia 0.5%, no WHO severity criteria, able to take oral medication). Oral Artemether/Lumefantrine (Riamet) is the recommended first-line ACT per UKHSA. It should be taken with fatty food to enhance Lumefantrine absorption. IV Artesunate is reserved for severe malaria. Chloroquine is ineffective against P. falciparum from sub-Saharan Africa. The patient should be admitted for monitoring (parasitaemia checks at 24, 48, and 72 hours).

Reference: UKHSA/UKMEAG 2016 – UK malaria treatment guidelines; BNF 2024 – Riamet