The usual suspect-malaria? Diagnostic challenges in post-artesunate delayed haemolysis: a clinical laboratory...

Malaria, a potentially fatal infectious disease, remains a significant global health concern, mainly in tropical regions. In Europe, its incidence is currently low and predominantly travel-related. Thus, a timely diagnosis requires healthcare teams to consider malaria in their differential diagnoses and obtain a thorough travel history. In medical laboratories, despite the present low case numbers, professionals must maintain a high diagnostic proficiency through continuous training and adherence to quality assurance programmes. First-line anti-malarial treatment with artemisinin derivatives is highly effective when implemented in a timely manner. However, as a consequence of their efficacy, a predictable haemolytic phenomenon may occur in some cases, which may be difficult to distinguish from manifestations of the disease itself. This mini review examines a case of travel-associated malaria to highlight diagnostic challenges from a medical laboratory perspective, with a particular focus on post-artesunate delayed haemolysis (PADH), a rare but potentially severe complication of malaria treatment.