A rare cause of fever in the emergency department

A rare cause of fever in the emergency department

Fever is one of the most frequent reasons for application to emergency service. Inflammatory diseases may vary from short-termed and self-limiting to serious conditions that may cause hospitalization at intensive care unit or death. Malaria is a disease with high mortality. We have aimed to submit a malaria case who has applied to emergency due to high fever and conscious change. A 52 years old male patient was brought to emergency by his relatives due to fever, headache, cold-shivering, conscious change at the periods with high fever. It was learnt that the patient had returned to Turkey 10 days ago from Africa where he had lived for the last six months. Systemic examination was normal and no organomegaly or icterus was observed in the patient. In thick smearing preparation, malaria forms were observed and in the thin smearing preparation, more than one ring-form gametocytes were observed and thus Plasmodium falciparum diagnosis was considered. Atovaquone/Proguanil 1x1 gr (3 days) treatment was started for the patient and he was hospitalized in the infections service. For the patients applied to emergency with high fever, travelling history should be investigated, malaria should be considered and early treatment should be started.

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  • Bozkurt S, Kökoğlu Ö, Okumuş M, İnci M, Güler S Malaria: A Disease That Should Not Be Forgotten in Emergency Service; Case Report. Tr J Emerg Med 2013; 13: 182-185.
  • Celikbas AK, Ergönül O, Baykam N, Eren S, Güven T, Dokuzoguz B. Malaria in Turkey and 14 years of clinical experience. Mikrobiyol Bul. 2006;40(3):237–243.
  • Fairhurst RM, Wellems TE. Plasmodium species (Malaria).In: Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases. 7th ed. Philadelphia: Churchil Livingstone; 2010. 3437-3462.
  • Knott JC, Tan SL, Street AC, Bailey M, Cameron P. Febrile adults presenting to the emergency department: outcomes and markers of serious illness. Emerg Med J 2004; 21.170-174.
  • Parlak E, Ertürk A, Çayır Y, Parlak M. Four Malaria-Import Patterns: Sporadic Region. Turkish journal of parasitology 2013; 37: 161-164.
  • Moody A .Rapid Diagnostic Tests for Malaria Parasites. Clin Microbiol Rev. 2002 Jan; 15(1): 66–78.
  • Ulçay A, Karaahmetoğlu G, Turhan V, Erdem H, Acar A, Oncul O, Gorenek L. The Management of Therapeutic Failure in a Falciparum Malaria Patient under Oral Arthemether Lumefantrine Therapy. Turkish journal of parasitology. 2014; 38: 61-67.
  • World Malaria Report 2015. https://www.who.int/malaria/publications/world-malaria-report-2015/en/. accessed: 05 October 2019).