Fever, headache, and abdominal pain in an African male

Principal Clinical Findings: The patient was a 44-year-old African male who had slightly decreased hemoglobin and hematocrit; decreased platelet count; increased serum glucose; increased total and indirect bilirubin; increased lactate dehydrogenase; and increased ferritin levels. Other History: The patient is a native of the Congo and recently traveled there with use of chloroquine as a prophylaxis against malaria. Most Likely Diagnosis: Co-infection with P. falciparum and P. ovale. Take-Home Message: Appropriate selection of antimalarial chemotherapy depends on not just the species of malaria present, but also the degree of parasitemia and the geographic/travel history of the patient. Most antimalarial treatments are well tolerated except for mefloquine whose potential side effects include neurotoxicity and cardiotoxicity.