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Malaria — RCPSC IM MCQ

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HardInfectious DiseasesMalariaRCPSC IM

A traveller returning from Ghana has confusion, jaundice, acute kidney injury and Plasmodium falciparum parasitemia of 6%. What is the best immediate treatment?

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Correct answer: A — Start intravenous artesunate with critical-care support

The best answer is “Start intravenous artesunate with critical-care support”. Neurologic dysfunction, kidney injury, jaundice and high parasitemia define severe malaria. Parenteral artesunate and urgent specialist supportive care are required; oral regimens and confirmatory delay are unsafe. After parenteral therapy, a complete oral antimalarial course and delayed-hemolysis monitoring are required according to the artesunate pathway.

Reference: CATMAT Canadian malaria treatment recommendations, full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC5864436/