Diagnostic Considerations
Severe and complicated malaria can be rapidly fatal, and wasting time is dangerous. Prompt diagnosis and immediate treatment with a drug known to be effective in the area where the malaria was acquired can be lifesaving. The presentation is varied and may suggest other conditions, such as meningitis, encephalitis, or epilepsy. Thus, cerebral malaria, and other forms of severe malaria, should be considered in the differential diagnosis of a febrile neurologic or other serious illness if a history of residence or travel through a malarious area exists.
Conditions to consider in the differential diagnosis of malaria include the following:
-
Ascending cholangitis
-
Enteric fever
-
Encephalitis
-
Heatstroke
-
Hepatitis
-
Lobar pneumonia
-
Pharyngitis
-
Viral pneumonia
-
Tonsillitis
-
Pelvic inflammatory disease
-
Bacteremia
-
Salmonella infection
-
Sinusitis
-
Tetanus
-
Giardiasis
-
Aseptic meningitis
-
Bacterial meningitis
-
Otitis media
-
Yellow fever
Differential Diagnoses
-
The various stages of Plasmodium life cycle are shown. Knowledge of the life cycle of the malarial parasite is essential to understanding the chemotherapy of malaria.
-
The various stages of Plasmodium vivax as observed on Giemsa staining of a peripheral blood smear.
-
The various stages of Plasmodium falciparum as observed on Giemsa staining of a peripheral blood smear are shown. The presence of more than one parasite in an erythrocyte is unique to this species.
