Malaria — RACP Paediatrics MCQ

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A 5-year-old presents 10 days after returning from Papua New Guinea with high spiking fevers, rigors, headache, and vomiting. Blood film shows ring forms within red blood cells with parasitaemia of 3%. What is the most likely diagnosis?

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Correct answer: E — Malaria

Malaria (most likely Plasmodium falciparum given PNG origin) must be considered in any febrile child with travel to an endemic area. Ring forms (trophozoites) on thick and thin blood films confirm the diagnosis. P. falciparum can cause severe/cerebral malaria and requires urgent treatment. Artesunate is the treatment of choice for severe malaria.

Reference: Australian Therapeutic Guidelines – 2024 – Antibiotic; RCH Melbourne – 2023 – Fever in Returned Traveller CPG