Nokea
A 23 year old female patient complains about periodical chill and body temperature rise up to 40oC, sense of heat taking turns with profuse sweating. The patient has had already 3 attacks that came once in two days and lasted 12 hours. She has lived in Africa for the last 2 months. Liver and spleen are enlarged. In blood: erythrocytes - 2,5x1012/l. What is the most probable diagnosis?
Correct Answer: A
Rationale: The most probable diagnosis is A: Malaria. The patient's symptoms of periodic chills, high fever, and profuse sweating, along with living in Africa where malaria is endemic, strongly suggest malaria. The enlarged liver and spleen are consistent with malaria infection. The low erythrocyte count indicates hemolysis, a common feature of malaria. Spotted fever and sepsis do not typically present with the same pattern of symptoms and travel history as seen in this case. Haemolytic anaemia would not explain the patient's fever episodes and other symptoms. Therefore, based on the symptoms, travel history, and laboratory findings, malaria is the most likely diagnosis.