- cyclical fevers are classic but not always present
- splenomegaly
- 'relapse' - relapsing malaria (hypnozooites of vivax or ovale), incomplete treatment or reinfection
Severe malaria (copied shamelessly from LITFL)
- CNS: Altered consciousness, (+/- meningism) seizures, focal deficits (cerebral malaria)
- GI: Vomiting, jaundice
- RESP: Respiratory distress +/- ARDS
- RENAL: AKI
- CVS: Shock
- HAEM: Severe haemolytic anaemia with jaundice, coagulopathies and spontaneous haemorrhage
- METABOLIC: acidosis and hypoglycemia
- high parasite load: >2% RBCs infected or >100,000 parasites/mm3
Diagnostic investigations
- blood films
- thick film: sensitivity +++, no species info
- Thin film: species, parasite count