A 9-year-old boy from a tribal district has insidious onset facial puffiness and proteinuria. Urine microscopy shows normal red cells, and renal biopsy demonstrates immune-complex glomerulonephritis. He had recurrent febrile episodes at exactly 72-hour intervals in the preceding year. The most likely causative agent is:

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

Explanation

Plasmodium malariae causes quartan fever with a 72-hour cycle and is classically associated with quartan nephrotic syndrome in children, an immune-complex glomerulopathy caused by deposition of antigen-antibody complexes in the glomeruli. It responds poorly to steroids. P. vivax and P. ovale produce tertian fever, and P. falciparum produces irregular fever with severe disease but not this chronic immune-complex nephropathy.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.