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April 22, 1944


JAMA. 1944;124(17):1179-1188. doi:10.1001/jama.1944.02850170015003

DIAGNOSIS  Malaria infections, either acute or chronic, may be suspected in persons who (a) give a history of having had an attack within the previous two or three years, (b) who have been residents or transients in an area where these diseases are endemic, (c) who exhibit an anemia or splenomegaly otherwise unexplainable, (d) who present an acute febrile illness characterized either by a remittent fever or by intermittent febrile paroxysms with or without rigors and unaccompanied by a leukocytosis and (e) who present any illness with a comatose onset. Furthermore, unsuspected chronic latent infections may become clinically activated by (a) a change in residence involving a material change in climate, (b) traumatic injury including surgical treatment and (c) confinement. The possibility of a malaria infection must not be overlooked in the recipient of a transfusion who develops fever.By the terms of our definition a definitive diagnosis must be

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