Best of Five 11

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BOF: 11

A 32-year-old male has returned from a holiday in Gambia six weeks ago.
He presents with fever, chills and rigors and on clinical examination is found to have an enlarged spleen.
Initial thin film examination for malarial parasites is negative.
You are aware that local experience and expertise in diagnosing malaria is not adequate
As the clinical suspicion of malaria is very high in this patient, what would your next course of action be?

a) Repeat the thin film examination in 48 hours

b) Do a thick film examination

c) Do a dipstick assay of Plasmodium Lactate dehydrogenase (pLDH)

d) Give empirical treatment for malaria

e) Repeat thick and thin films in 72 hours

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