Mixed infections involving more than one species of Plasmodium may occur in areas of high endemicity (have a low threshold for including treatment for P falciparum)
Hyponatremia in the setting of hypovolemia does not require treatment beyond rehydration
Treat hypoglycemia
Check HIV status (coinfection can lead to worse clinical outcomes)
Exchange transfusion for patients with:
P falciparum<unk>  with a parasitemia greater than 10%
Life-threatening complications (ie, coma, respiratory failure, coagulopathy, fulminant kidney failure)
P falciparum<unk>  with a parasitemia greater than 10%
Life-threatening complications (ie, coma, respiratory failure, coagulopathy, fulminant kidney failure)
Uncomplicated:
No evidence of organ dysfunction
Parasitemia <5%
Able to tolerate PO
Hospitalize:
Severe clinical manifestations in non-immune host for P. falciparum or P. knowlesi
Report to state health department
For non-pregnant patients (3 day course)
Artemether + lumefantrine
Artesunate + amodiaquine
Artesunate + mefloquine
Dihydroartemisinin + piperaquine
Artesunate + sulfadoxine–pyrimethamine (SP)
For pregnant (1st trimester)
Quinine + clindamycin x 7 days
Additional considerations
Avoid artesunate + SP in HIV/AIDS patients taking co-trimoxazole
Avoid artesunate + amodiaquine in HIV/AIDS patients taking efavirenz or zidovudine
P. vivax and P. ovale have dormant hypnozoites in the liver which require treatment with primaquine phosphate for complete eradication
No evidence of organ dysfunction
Parasitemia <5%
Able to tolerate PO
Severe clinical manifestations in non-immune host for P. falciparum or P. knowlesi
Artemether + lumefantrine
Artesunate + amodiaquine
Artesunate + mefloquine
Dihydroartemisinin + piperaquine
Artesunate + sulfadoxine–pyrimethamine (SP)
Quinine + clindamycin x 7 days
Avoid artesunate + SP in HIV/AIDS patients taking co-trimoxazole
Avoid artesunate + amodiaquine in HIV/AIDS patients taking efavirenz or zidovudine
P. vivax and P. ovale have dormant hypnozoites in the liver which require treatment with primaquine phosphate for complete eradication
Do not delay treatment in the unstable patient if strong suspicion for<unk>  as initial smear may be falsely negative
Treatment (IV for ≥24 hours then 3 days PO course)
Artesunate (IV)
Clears<unk>  faster than quinine
Distributed only through CDC
Quinidine (IV) also appropriate choice; more available in US
Artesunate (IV)
Clears<unk>  faster than quinine
Distributed only through CDC
Quinidine (IV) also appropriate choice; more available in US
Clears<unk>  faster than quinine
Distributed only through CDC
Insufficient evidence for or against giving antiepileptics
For severe cerebral edema, mannitol and steroids have not shown a demonstrable benefit
Malaria
Normal causes of acute fever!
Chikungunya
Cholera
Dengue
Babesiosis
Leptospirosis
Typhoid fever