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Plasmodium knowlesi malaria — DTM&H MCQ

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HardMalariaPlasmodium knowlesi malariaDTM&H

A 39-year-old man develops fever, myalgia and thrombocytopenia 10 days after working in forested Sabah, Malaysia. Blood film shows malaria parasites, but the laboratory notes band forms and high parasitaemia with a 24-hour fever pattern. What is the most likely diagnosis?

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Correct answer: E — Plasmodium knowlesi malaria

P. knowlesi is associated with forest exposure in Malaysian Borneo and may resemble P. malariae microscopically, but it can multiply every 24 hours and cause severe disease. P. malariae usually has a 72-hour cycle and is less commonly associated with rapidly high parasitaemia. The key point is that zoonotic malaria should be considered in travellers with compatible Southeast Asian forest exposure.

Reference: Manson's Tropical Diseases; WHO Guidelines for malaria