An 8-year-old girl from a coastal village presents with facial puffiness and frothy urine. Urinalysis shows heavy proteinuria without hematuria, and serum albumin is low. Renal biopsy demonstrates granular deposits of IgG and C3 along the glomerular basement membrane. Her history includes recurrent febrile episodes every 72 hours documented over the past year. The most likely underlying parasite is:

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

Explanation

Plasmodium malariae produces quartan fever with a 72-hour cycle and is classically associated with quartan nephropathy, an immune complex mediated glomerulonephritis presenting as nephrotic syndrome in children. Deposits of IgG, IgM, and A3 are granular along the basement membrane. Falciparum and vivax malaria rarely cause this chronic glomerulopathy, and P. vivax produces tertian fever at 48 hours rather than the 72-hour periodicity described here.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.