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Malaria recrudescence — DTM&H MCQ

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EasyMalariaMalaria recrudescenceDTM&H

A 28-year-old man treated for falciparum malaria with incomplete adherence develops fever 3 weeks later. Blood film again shows Plasmodium falciparum with low parasitaemia. What is the most likely diagnosis?

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Correct answer: ERecrudescence of falciparum malaria

Recrudescence of falciparum malaria is the single best answer because reappearance of falciparum parasitaemia after inadequate or failed blood-stage treatment is recrudescence. Vivax relapse is plausible in a related presentation, but it is less appropriate because it does not fit the key discriminator in this vignette. The teaching point is that vivax and ovale relapse arises from hypnozoites, which falciparum does not form.

Reference: WHO Guidelines for malaria, 2025; UKHSA Malaria prevention guidelines for travellers from the UK, 2025; CDC Yellow Book 2026