The Rational Clinical Examination
David L. Simel, Drummond Rennie
Malaria
Steve M. Taylor, Malcolm E. Molyneux, David L. Simel, Steven R. Meshnick, Jonathan J. Juliano
Sections:
Clinical Scenarios, Why Is the Clinical Examination Important?, Methods, Results, Scenario Resolution, Clinical Bottom Line, References
Topics Discussed:
malaria, parasitemia
Excerpt:
"A 3-year-old girl presents to a clinic in Lilongwe district,
Malawi, with 3 days of fever. Her mother noted no other symptoms,
including chills or rigors, headache, or joint aches. The child feels
warm and has general pallor, but has clear lungs and a nonpalpable
liver and spleen. Malawi is endemic for malaria but the clinic does
not have facilities to test blood for malaria parasites. Guidelines
from the World Health Organization recommend that in such circumstances
all febrile children without other obvious etiologies for fever
should be treated empirically for malaria. Are the history and physical
examination of this patient sufficient grounds for the provision
of empirical therapy?..."
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