Malaria
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Malaria
- most imp cause of fvr
- plasmodium falciparum can be rapidly fatal and needs to be ruled out soon
- p falciparum from sub Saharan Africa, 90% of pt have sx within 1 mo of return
- p vivax- Asia and Latin, 50% pt have sx within 1 mo- 2% up to 1 yr out
- chemoprophylaxsis does not guarantee protection
- usually have fvr, but 10- 40% may not
- fvr q 48- 72 hr pathognomic of vivax, ovale, malariae infc
- can also have ha, cough, gi sx
- check thick smear initially and if neg, repeat in 12- 24 hrs
- thrombocytopenia and splenomegaly common
- p falciparum unpredictable- admit and monitor for hypoglycemia
- iv meds if renal, resp failure, ams, sx, shock, anemia, p falcip rbc load >4% in nonimmune pt