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Falciparum malaria evaluation — ABIM Board MCQ

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ModerateInfectious DiseaseFalciparum malaria evaluationABIM Board

A 29-year-old man returns from Ghana with fever, chills, headache, and myalgias. He did not take malaria prophylaxis. Temperature is 39.4 C and blood pressure is 118/70 mm Hg. Platelets are 82,000/mm3, bilirubin is 2.1 mg/dL, and creatinine is 1.1 mg/dL. Rapid influenza and COVID tests are negative. Which of the following is the most appropriate diagnostic study?

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Correct answer: C — Urgent thick and thin blood smears for malaria with rapid antigen testing

Fever after travel to sub-Saharan Africa is malaria until proven otherwise. Thick and thin smears with rapid diagnostic testing should be obtained urgently, with repeat smears if initial testing is negative and suspicion remains.

Reference: CDC Yellow Book; IDSA Travel Medicine Guidance