A non-immune traveller with 12% Plasmodium falciparum parasitaemia and AKI responds to intravenous artesunate and completes oral follow-on therapy.

Question

A non-immune traveller with 12% Plasmodium falciparum parasitaemia and AKI responds to intravenous artesunate and completes oral follow-on therapy. He is clinically well at discharge with haemoglobin 118 g/L. Which planned follow-up detects the characteristic delayed treatment complication?

Accepted Answer

Repeat haemoglobin at approximately 14 days and counsel about delayed haemolysis symptoms

Answer

Measure G6PD activity weekly because artesunate predictably causes oxidant haemolysis only in deficiency

Answer

Arrange liver ultrasound at 7 days to detect artesunate-associated biliary obstruction

Answer

Repeat a malaria rapid antigen test at 48 hours because persistent antigen proves treatment failure

Answer

Start prophylactic chloroquine for 28 days to prevent artesunate resistance

Severe falciparum malaria — SCE Acute Medicine MCQ

A non-immune traveller with 12% Plasmodium falciparum parasitaemia and AKI responds to intravenous artesunate and completes oral follow-on therapy. He is clinically well at discharge with haemoglobin 118 g/L. Which planned follow-up detects the characteristic delayed treatment complication?