A 24-year-old male returns from a trip to Ghana with a 3-day history of fever, chills, and sweating. He also reports headache, muscle aches, and mild nausea. No history of rash, joint pain, or bleeding. On examination, he has mild pallor and splenomegaly, but no signs of severe illness. Differential Diagnosis: Malaria (Plasmodium falciparum or vivax) Dengue fever Typhoid fever Leptospirosis Investigations: Thick and thin blood smear → Plasmodium vivax detected. Rapid Diagnostic Test (RDT) → Positive for malaria. CBC → Mild anemia, thrombocytopenia. Liver function tests → Mild elevation of transaminases. Management: Oral Artemisinin-based Combination Therapy (ACT) (e.g., Artemether-Lumefantrine). Primaquine for P. vivax to prevent relapse. Supportive care: Fluids, antipyretics (paracetamol). Key Learning Points: Uncomplicated malaria presents with cyclical fever, chills, and sweating. Diagnosis requires a blood smear or RDT to differentiate species. P. vivax requires primaquine to eliminate liver hypnozoites.
