Symptoms of Malaria but Tests Negative

QUESTION

My sister has been suffering from fever from past 22 days temperature varying from 102-106 with chills shivering, headache, body pain,nausea and muscle ache but tested negative for malaria. She also tested negative for dengue, swine flu, hiv, and many others.  So out of frustration we gave her mefloc 250 and she seems to be responding. She is still having fever that is after 12 hrs of medication but the temprature is ranging between 98-100 and there is no headache and no chills and shivers.  Now we are confused how to confirm that it is really malaria and when will the fever stop completely. Should we shift her to a some other hospital at present she is in Pune.

ANSWER

The diagnosis of malaria is confirmed by observing parasites on a blood smear.  There are also Rapid Diagnostic Tests (RDT) that can be done with a pin prick of blood, but the blood smear is the definitive test. It is possible, that in your sister’s case,  a proper malaria test was not done or not interpreted correctly, and she does have malaria and it is responding to the medicine.   Alternatively it could be that your sister does not have malaria, but suffers from another problem that coincidentally is resolving itself at the same time the anti-malarial medicine is given.  It is hard to determine exactly what is wrong, but the good news is that she is getting better.

Sometimes medicine is given on presumption of illness which is what happened in your sister’s case. However, if someone has uncomplicated falciparum malaria, (most prevalent in India)  WHO recommends Artemisimin Combined Therapy (ACT), which uses an artemisinin compound with another anti malarial, such as mefloquine, not mefloquine alone.  If your sister’s fever returns, make sure to have a blood smear taken to see if it is malaria or not, and if so what kind of malaria it is, to better tailor her medicine.

Comments

  1. Jennifer says:

    My 2yr old daughter had malaria symptoms 2weeks ago with temp. of 37.6c. She was treated for malaria with Coartem.just yesterday, the symptoms returned with 38.6c temp. She undertook malaria blood smear test and it was negative.what do i do.

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    • A temperature of 37.6 in a child of two is actually not a very high fever at all – did you test her for malaria before treatment? 38.6 is also still considered a low-grade fever, and could be due to side effects of the medication, or perhaps some other ailment. Without more symptoms, it is difficult to know what could be causing the illness, but if the malaria test is negative, it probably is not malaria.

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