A traveler returning from Sub-Saharan Africa presents with cyclical high fevers, rigors, and hemolytic anemia. Blood smear reveals Plasmodium falciparum ring forms. What is first-line therapy?
Answer and explanation
Correct answer: A. Artemisinin-based combination therapy
- Step 1: Plasmodium falciparum is the most virulent malaria species, responsible for severe cerebral malaria and complications.
- Step 2: Due to widespread chloroquine resistance, the World Health Organization mandates artemisinin-based combination therapy (ACT, such as artemether-lumefantrine) as first-line therapy for uncomplicated falciparum malaria.
Answer
Artemisinin-based combination therapy.
Why not the others: Chloroquine resistance is widespread across Sub-Saharan Africa, and its use leads to treatment failure and fatal complications. Acyclovir is an antiviral agent for herpes simplex and varicella zoster with no activity against protozoa. Metronidazole is an antiparasitic for anaerobic bacteria and luminal protozoa like Entamoeba and Giardia.
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