Case 7

Question 1

Female patient P., 62 years old, called a doctor due to poor health, fever, headache, nausea, and vomiting with a rise in body temperature. The patient had been ill for several days. Before going to the doctor, she had an increased body temperature of 39 ’C, which was accompanied by shaking chills and fever; then, after a few hours, profuse sweating began, body temperature decreased to subnormal values, the condition improved; a day later, the patient experienced a similar feverish condition again. The examination revealed pallor of the skin with a yellowish discoloration and enlargement of the liver and spleen. Epidemiological history: the patient rested in India 12 days before the development of the disease. Task 1. Make a diagnosis and provide its justification. 2. Make an examination algorithm. 3. Name the principles of etiotropic therapy for this disease. 4. Make a list of individual prevention activities for this disease.

Answer 1

Malaria (probably caused by P. vivax), primary, uncomplicated.

Diagnosis: Malaria. The patient’s symptoms, including fever, headache, nausea, vomiting, and chills, are consistent with malaria. The presence of yellowish discoloration of the skin, enlargement of the liver and spleen, and recent travel to India further support this diagnosis.

Question 2

Make an examination algorithm.

Answer 2

Examination algorithm: The examination algorithm should include a thorough medical history, physical examination, and laboratory testing.

Laboratory testing should include a blood smear (thick or thin smear, ) to confirm the presence of the malaria parasite and determine the species of the parasite.

Fluorescent microscopy

Other laboratory tests, such as complete blood count, liver function tests, and renal function tests, may also be necessary to assess the severity of the disease and monitor for complications.

Question 3

Name the principles of etiotropic therapy for this disease.

Answer 3

The patient should be treated with antimalarial medications, such as artemisinin-based combination therapy (ACT) or quinine-based therapy, depending on the species of the parasite and the severity of the disease. Supportive care, such as fluids and electrolyte replacement, may also be necessary for patients with severe malaria.

Yes, the treatment of malaria depends on the species of the parasite and the severity of the disease. The following are some examples of antimalarial drugs and their combinations:

1.	Artemisinin-based combination therapy (ACT): ACT is the recommended first-line treatment for uncomplicated malaria caused by Plasmodium falciparum. ACT combines an artemisinin derivative, such as artemether or artesunate, with a longer-acting antimalarial drug, such as lumefantrine or mefloquine.
2.	Chloroquine: Chloroquine is an effective treatment for uncomplicated malaria caused by Plasmodium vivax, Plasmodium ovale, and some strains of Plasmodium malariae. Chloroquine is usually given in combination with primaquine to prevent relapse of P. vivax and P. ovale.
3.	Quinine: Quinine is an effective treatment for severe malaria caused by P. falciparum. Quinine is usually given in combination with doxycycline or clindamycin.
4.	Atovaquone-proguanil: Atovaquone-proguanil is an effective treatment for uncomplicated malaria caused by P. falciparum and P. vivax. Atovaquone-proguanil is usually given as

Question 4

Make a list of individual prevention activities for this disease.

Answer 4

Individual prevention activities: To prevent malaria, the patient should take measures to avoid mosquito bites, such as using insect repellent, wearing protective clothing, and sleeping under mosquito net .