A 53 year old female presented with fever, rigors, malaise, and headaches for the past 2 days. She had lived in Zaire for 8 months, where she had been hospitalized with similar complaints and treated empirically with chloroquine.

 She returned to the US two days prior to admission. Her temperature was 102 degrees, Pulse 90, and BP 130/70. On physical examination, the spleen tip was palpable. The WBC count was 4100 / mm3, and the hemoglobin was 8.5 g /dl.

1. What test would help establish the diagnosis in this patient?    Answer

2. What plasmodium species is Likely to be causing her infection? List the species and their geographical distribution.   Answer

3. Which species causes the most severe diseases, and what complications are seen with it?   Answer

4. What is the life cycle of the species you think is involved?   Answer

5. Why had she failed treatment previously? How would you treat this patient?    Answer

6. What control measures are available to prevent its transmission?    Answer