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Things to do routinely a. Thick blood films to evaluate for malaria. In endemic areas, remember fever may be caused by something other than malaria in patients with (+) films. Malaria can cause acute, chronic, or relapsing fever. Malaria is highly suspicious when fevers occur every (q) 48-72 hours but may usually take 2 weeks for schizontocytes to become synchronized. Plasmodium falciparum rarely develops such a fever pattern. b. Complete blood count with differential (CBC with differential [w/ diff ]) i. Malaria will usually have normal or low white blood cell count (WBC), often with thrombocytopenia. ii. With leukocytosis (especially with left shift), even patients with a (+) film are very likely to have a cause other than malaria. c. Begin a fever chart: 4-hour intervals are most useful. d. Check for rash, lymphadenopathy (LAD), splenomegaly, anemia, jaundice, polyarthritis, and so on.Acute Fevers (<2 Weeks) 1. Acute fever + negative malarial film a. Polymorphonuclear leukocytosis (PNL)? i. Yes: pyogenic infection, leptospirosis, relapsing fever, amebic hepatic abscess, collagenvascular disease (collagenosis) ii. No: viral infection, rickettsial infection, typhoid ■ PNL often do
- Author
- Saif Al-Bedwawi; Amanda Huston
- Publisher
- Elsevier
- Published
- 2023
- Language
- EN
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