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P. falciparum Malaria — RACP Adult Medicine MCQ

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ModerateInfectious DiseasesP. falciparum MalariaRACP Adult Medicine

A 30-year-old man returned from Papua New Guinea 10 days ago presents with cyclical fevers every 48 hours, rigors, headache, and splenomegaly. Blood film shows ring-form trophozoites within red blood cells with >5% parasitaemia. Some red cells contain multiple rings. What is the most likely species?

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Correct answer: A — Plasmodium falciparum

High parasitaemia (>5%), multiple ring forms per RBC, and travel to PNG (highly endemic for P. falciparum) is falciparum malaria. P. falciparum is the most dangerous species (cerebral malaria, severe anaemia, ARDS, hypoglycaemia, renal failure). Treatment of severe falciparum (parasitaemia >2%, signs of severity): IV artesunate. Uncomplicated falciparum: artemether-lumefantrine (Riamet). Admission and monitoring until parasitaemia clearing.

Reference: eTG Antibiotic – 2025 – Malaria; WHO 2024