Fever from Africa…..

Just stop right there. It’s not ebola.

It’s malaria (unless the patient is uncontrollably vomiting blood or has participated in the cultural burial practices of West Africans within the past couple of weeks).

Seeing as I’ve had two patient’s with malaria, I thought it’d be nice to share some of the great resources I’ve come across (had med students look up), while treating these guys.

1. First off is the CDC malaria map: http://cdc-malaria.ncsa.uiuc.edu

You can see where malaria is endemic, and you click on different countries to see speciation and resistance.

2. Next is the CDC treatment recommendations: http://www.cdc.gov/malaria/resources/pdf/treatmenttable.pdf

Get a good history and know where the patient has travelled. This has doses for adults and children, so it can be useful at Kosair or out in the community too.

3. Clinical Pearls

  • Transmitted by the Anopheles Mosquito
  • Classically will have fevers/symptoms spiking every 24/48 hours
  • Severe Malaria (ICU admission): AMS, severe anemia, DIC, parasitemia >5%, metabolic acidosis, AKI/liver injury, hypoglycemia
  • Probably best to admit/observe all patients until you have a viral load and get treatment started at the hospital. Some of the antimalarials can be hard to come by and these patient’s can get sick.