[Malaria]

Imported malaria is an important problem in non-endemic areas because of increasing numbers of travelers, overseas workers and immigrants. Since the presentation of malaria is vague and nonspecific, the diagnosis should be considered in any appropriately symptomatic patient with a history of travel to a malaria-endemic area. If the diagnosis is not made in about one day, the disease can have a fatal outcome. Microscopy of thick and thin blood smears remains the standard laboratory method, although also polymerase chain reaction has become an important diagnostic and research technique in malaria. The main classes of drugs used are the quinoline-related compounds (chloroquine, mefloquine, primaquine), atovaquon/proguanil and the artemisinin derivatives. Management of severe and complicated malaria requires special attention: patients have to be admitted to an intensive care unit, supportive measures must be initiated, and parenteral treatment with quinine should be started as quickly as possible.