Blood film examination of a patient with high-grade fever, thrombocytopenia, and jaundice shows multiple ring forms per erythrocyte, infected cells of normal size, and no visible schizonts. Creatinine is 3.1 mg/dL. Which Plasmodium species and complication are most consistent?

• A P. vivax; benign tertian malaria
• B P. malariae; quartan malarial nephropathy
• C P. falciparum; severe malaria with acute kidney injury ✓
• D P. ovale; relapsing malaria

Explanation

Multiple rings per erythrocyte, normal cell size, and absence of peripheral schizonts are hallmarks of P. falciparum; AKI (creatinine >3 mg/dL) with jaundice and thrombocytopenia fulfills WHO criteria for severe malaria. P. vivax enlarges erythrocytes, forms Schüffner's dots, and rarely causes AKI. P. malariae causes quartan fever with membranoproliferative nephropathy over years. P. ovale has fimbriated ('fimbriated' or 'ragged') cells.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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