An 8-year-old boy from Odisha presents with generalised oedema and proteinuria meeting criteria for nephrotic syndrome. Renal biopsy shows mesangial proliferative glomerulonephritis. Thick blood film shows erythrocytes containing band-shaped trophozoites stretched across the red cell, and the fever pattern recurs every 72 hours. The causative species is:

• A Plasmodium vivax
• B Plasmodium falciparum
• C Plasmodium ovale
• D Plasmodium malariae ✓

Explanation

Band-form trophozoites spanning the erythrocyte, a 72-hour quartan periodicity, and quartan nephropathy in children are classic for Plasmodium malariae. Quartan nephrotic syndrome results from immune complex deposition in the glomerulus and responds poorly to steroids. Vivax and ovale show Schuffner dots and 48-hour cycles, while falciparum shows ring forms and banana-shaped gametocytes with irregular 36 to 48 hour fever patterns and does not cause this nephropathy.

Reference: Paniker's Textbook of Medical Parasitology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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