[Diagnosis and management of imported malaria]

Any fever in a traveller returning from a tropical area has to be considered first as a malaria attack and needs a parasitological diagnosis. Nevertheless, physicians have to be aware of atypical presentations (lack of fever, febrile enteritis, false negative smear...). In non-falciparum malaria, chloroquine remains the drug of choice. In falciparum-malaria, an ambulatory treatment by the association atovaquone-proguanil or oral quinine is possible only if certain criteria are respected. On the opposite, only one sign of severity (including mild consciousness disorders) implies a transfer in an intensive care unit for emergency treatment with IV quinine including a loading dose. A follow-up with clinical and parasitological assessment at D3, D7 and D28-35 is an important aspect in the management of a malaria case.