ELEVEN-YEAR-OLD GIRL WITH PLASMODIUM FALCIPARUM MALARIA AND NEPHROTIC SYNDROME

An 11-year-old African-American girl presented to our Emergency Department complaining of severe headache, fever to 104.4 degree F and vomiting. Symptoms had begun 2 days previously during a return airplane flight after a 3-week vacation in urban areas of Nigeria. She had been taking weekly chloroquine tablets for malaria prophylaxis. Plasmodium inclusions were present in 7% of erythrocytes, and falciparum species was diagnosed on the basis of the presence in cells of multiple developmental stages. Therapy was started with intravenous quinidine for 72 hours and oral tetracycline for 7 days. The percentage of infected erythrocytes decreased to