He had a fever when he was in Spain, And when the fit was on him, I did mark How he did shake; 'tis true, this god did shake…

WILLIAM SHAKESPEARE

Julius Caesar

Malaria is one of the most common infectious illnesses in the world. Plasmodium falciparum, accounting for nearly all malaria mortality, kills an estimated 1 to 2 million persons yearly. A wide range in clinical response to malaria exists, based on the degree of immunity, patient age, and duration of infection. Falciparum malaria can progress rapidly, with a lucid patient becoming obtunded in minutes. If major organ system dysfunction such as cerebral malaria develops, the risk of death is 20%, even with proper therapy. This rapid progression to complicated malaria is most common in those without immunity, such as children in the tropics or travelers from temperate zones.

This article discusses the early diagnosis of falciparum malaria. The recent literature on epidemiology, diagnosis, treatment, and prophylaxis of malaria is reviewed from the viewpoint of the physician in a temperate zone. Although one of the world's most devastating diseases, falciparum malaria is treatable, and attention to detail will reduce morbidity and mortality.