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Imported malaria — SCE Acute Medicine MCQ

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ModerateSepsis and Infectious EmergenciesImported malariaSCE Acute Medicine

A 35-year-old man is assessed on the acute medical unit. He has fever, headache and thrombocytopenia after returning from Nigeria. He took no chemoprophylaxis and has mild jaundice. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate investigation?

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Correct answer: B — Thick and thin blood films urgently

Thick and thin blood films urgently is the best answer because malaria must be excluded rapidly with urgent blood films in febrile travellers from endemic regions. Bedside capillary ketones and venous blood gas is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Falciparum malaria can deteriorate quickly even when initial symptoms look non-specific.

Reference: https://www.gov.uk/government/organisations/uk-health-security-agency#acute-medicine-order-65-1