Taking into account biological abnormalities for the diagnosis of malaria

Resistance-induced low parasitemia has complicated the diagnosis of malaria, especially in general practice or in small hospitals where new diagnostic techniques are unavailable. For a patient coming from an endemic area, routine biochemical and hematological parameters may be helpful for the diagnosis because of their prevalence in acute malaria, especially if several of them are associated: such is the case for thrombopenia, atypical lymphocytes, marked hypocholesterolemia and hypohaptoglobinemia, raised C-reactive protein, and LDH. Nevertheless, none of these parameters can be considered as fully reliable: the diagnostic procedure must include epidemiological as well as clinical data, and hemoparasitic evidence should be obtained, as often as possible, with no further delay in treatment if Plasmodium falciparum is suspected. (C) 1999 Editions scientifiques et Medicales Elsevier SAS.