A 32-year-old woman presents to the clinic with a three-day history of fever, headache, chills, and malaise. She also reports nausea and episodes of vomiting. She returned from a trip to sub-Saharan Africa five days ago, where she did not take malaria prophylaxis. Her travel included time spent in rural areas with significant mosquito exposure. Her past medical history is unremarkable, and she is not on any medications. She denies alcohol or tobacco use but mentions occasional recreational marijuana use. Her temperature is 102.2°F (39.0°C, blood pressure is 132/71 mm Hg, heart rate is 110 beats/min, and respirations are 18. On physical examination, she has scleral icterus and tachycardia. Laboratory results reveal anemia, thrombocytopenia, and elevated bilirubin. A peripheral blood smear shows ring forms within erythrocytes.
Which of the following is the most appropriate initial treatment?
- A) Artemether-lumefantrine
- B) Doxycycline
- C) Mefloquine
- D) Primaquine
- E) Quinine and clindamycin
Author(s)
Dr. Ted O'Connell
Editor(s)
Dr. Ted O'Connell
Last updated
Apr 18, 2025
