Question

Upon returning to the US, a very sick young man has connected to a hospital's emergency room. he was visiting Thailand and hiking in Eastern Burma. His most pronounced symptom is a severe headache. He had a fever of 103 F Later his bed sheets become soaked in sweat. A physical examination reveal no abnormalities; neck supple, lungs clear, heart regular, abdomen soft, skin unblemished. A spinal tap analysis is negative for meningitis. A quick neurological exam indicated nothing that it might be a brain tumor, stroke or an abscess. His blood count had been rapidly decreasing on the last count, it showed that 45% of his red blood cells are gone. His urine is extremely dark. An examination of the smear reveals that in the middle of one of the red blood cells is a bluish, circular band crowned by a tiny ruby, like a signet ring.

Name of the infection______________________

Answer 1

ANSWER: The patient is suffering from Malaria caused by Plasmodium species and in this patient most probably it might be Plasmodium falciparum. The balck urine and reduction in the red blood cells with high fever are the characteristic feature of Malaria. The blackwater fever is due to increased hemolysis and also on smear examination the red cells showed signet cells which is also a characteristic feature of malaria.