A 26-year-old woman presents to a UK hospital 9 days after returning from Cameroon. She took no malaria prophylaxis. She reports 2 days of fever, vomi...

Question

A 26-year-old woman presents to a UK hospital 9 days after returning from Cameroon. She took no malaria prophylaxis. She reports 2 days of fever, vomiting, and confusion. On examination, she is drowsy (GCS 13), temperature 39.6°C, blood pressure 95/60 mmHg. Blood glucose is 1.8 mmol/L. Thick film shows P. falciparum at 6% parasitaemia. After commencing IV artesunate, what is the most urgent additional intervention?

Accepted Answer

Intravenous dextrose bolus to correct hypoglycaemia

Answer

Immediate exchange transfusion

Answer

Intravenous dexamethasone to reduce cerebral oedema

Answer

Lumbar puncture to exclude bacterial meningitis

Answer

Urgent CT brain scan

uk-dtmh MCQ (SBA): Severe Malaria with Hypoglycaemia