skip to main content

Falciparum malaria — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateSepsis and Infectious EmergenciesFalciparum malariaSCE Acute Medicine

A 32-year-old man returns from Nigeria with fever, jaundice and confusion. Thick and thin films show Plasmodium falciparum parasitaemia of 6%. Platelets are 42 x10^9/L, creatinine is 198 micromol/L and glucose is 2.8 mmol/L. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Start intravenous artesunate and involve infectious diseases urgently

Confusion, renal impairment, hypoglycaemia and high parasitaemia indicate severe falciparum malaria, requiring IV artesunate and specialist input. Chloroquine is not appropriate for falciparum acquired in West Africa because of resistance. Waiting for repeat films would delay treatment. The pearl is that travel history plus thrombocytopenia should trigger urgent malaria testing in fever.

Reference: UK malaria treatment guidelines; BNF