At present, approximately 3,000 cases of malaria are reported annually in the United States. Both civilian and military travelers, following ineffective or interrupted prophylaxis, may first become ill months after return from overseas. From these carriers, nontravelers may become infected via venipuncture, mosquito bite, or placental transfer. Recent studies have revealed new clinical and pathologic data concerning pulmonary, hepatic, renal, vascular, hematologic, and psychiatric manifestations of malaria. Because of long latent periods or unusual modes of acquisition, a physician in any field of practice may first see the patient with malaria. The diagnosis is easily overlooked because of nonspecific findings, with possible fatal consequences. A suspected diagnosis is confirmed relatively easily by persistent search of ordinary blood smears. The critical distinction between falciparum and the benign malarias can usually be made by fairly simple criteria.
Heineman HS. The Clinical Syndrome of Malaria in the United States: A Current Review of Diagnosis and Treatment for American Physicians. Arch Intern Med. 1972;129(4):607–616. doi:10.1001/archinte.1972.00320040083011
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