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Ovid: Oxford Handbook of Tropical Medicine

Editors: Eddleston, Michael; Pierini, Stephen; Wilkinson, Robert; Davidson, Robert Title: Oxford Handbook of Tropical Medicine, 2nd Edition Copyright ©2005 Oxford University Press (Copyright 2005 by M. Eddleston, S. Pierini, R. Wilkinson, and R. Davidson) > Table of Contents > Chapter 2 > Chapter 2A – Malaria > Differential diagnosis Differential diagnosis Malaria is a great mimic and must enter the differential diagnosis of several clinical presentations.

  • The presentation fever needs to be differentiated from other endemic diseases such as typhoid, viral illnesses such as dengue fever and influenza, brucellosis, and respiratory and urinary tract infections. Less common causes of tropical fevers include leishmaniasis, trypanosomiasis, rickettsial infections, and relapsing fevers.
  • The coma of CM needs to be differentiated from meningitis (including tuberculous meningitis), encephalitis, enteric fevers, trypanosomiasis, brain abscess, and other causes of coma.
  • The anaemia of malaria can be confused with other common causes of haemolytic anaemia in the tropics such as that due to the haemoglobinopathies. The anaemia of malaria must be differentiated from that of iron, folate, or vitamin B12 deficiency.
  • The renal failure of malaria must be distinguished from massive intravascular haemolysis, sickle cell disease, leptospirosis, snake envenoming, use of traditional herbal medicines, and chronic renal disease resulting from glomerulonephritis and hypertension.
  • The jaundice and hepatomegaly of malaria must be distinguished from that of viral hepatitis (A, B, and E, cytomegalovirus, and Epstein–Barr virus infections), leptospirosis, yellow fever, biliary disease, and drug-induced disease including alcohol.

Clinical diagnosis on its own is notoriously inaccurate in the diagnosis of malaria and a blood film is desirable.

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