A farmer has had febrile episodes recurring every 72 hours for several months. Thin blood films show trophozoites stretched across the red cell as a band, in erythrocytes that are not enlarged. Which complication develops years later, classically in children with this infection?

• A Blackwater fever
• B Nephrotic syndrome from immune complex glomerulonephritis ✓
• C Cerebral malaria
• D Acute pulmonary oedema

Explanation

Plasmodium malariae causes quartan fever and shows band form trophozoites in normal sized erythrocytes. Its classical late complication is quartan nephrotic syndrome in children, caused by chronic deposition of circulating immune complexes containing parasite antigen in the glomeruli; it responds poorly to antimalarials and may progress to renal failure. Blackwater fever and cerebral malaria are complications specific to falciparum infection, which eliminates those distractors.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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