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Pathogenic Parasites

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A 30-year-old man returned to the United States 3 weeks ago from a guided tour of Thailand. On advice of his physician, he took oral chloroquine prophylaxis beginning 1 week before departure and ending 1 week after his return. Over the last 4 days, he has developed repeated episodes of fever to 40°C, preceded by chills and associated with a severe headache. The duration of these symptoms has been about 8 hours, ending with profuse sweating, only to recur again within 48 hours.

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Physical examination is unremarkable, except for fever.

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Laboratory studies reveal only a mild anemia, with a platelet count of 100 000/mm3 (normal 200 000-400 000).

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Which is the most likely diagnosis for this patient?

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A. Vivax malaria

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B. Falciparum malaria

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C. Toxoplasmosis

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D. Ovale malaria

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E. Malariae malaria

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A 30-year-old man returned to the United States 3 weeks ago from a guided tour of Thailand. On advice of his physician, he took oral chloroquine prophylaxis beginning 1 week before departure and ending 1 week after his return. Over the last 4 days, he has developed repeated episodes of fever to 40°C, preceded by chills and associated with a severe headache. The duration of these symptoms has been about 8 hours, ending with profuse sweating, only to recur again within 48 hours.

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Physical examination is unremarkable, except for fever.

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Laboratory studies reveal only a mild anemia, with a platelet count of 100 000/mm3 (normal 200 000-400 000).

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The diagnostic test of choice is:

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A. Peripheral blood smears

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B. PCR of red blood cells

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C. IgM ELISA serology

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D. Paired sera for IgG antibody quantitation

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A 30-year-old man returned to the United States 3 weeks ago from a guided tour of Thailand. On advice of his physician, he took oral chloroquine prophylaxis beginning 1 week before departure and ending 1 week after his return. Over the last 4 days, he has developed repeated episodes of fever to 40°C, preceded by chills and associated with a severe headache. The duration of these symptoms has been about 8 hours, ending with profuse sweating, only to recur again within 48 hours.

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Physical examination is unremarkable, except for fever.

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Laboratory studies reveal only a mild anemia, with a platelet count of 100 000/mm3 (normal 200 000-400 000).

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In some malarial ...

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