130.2 📚 國考版

130.2.0.1 必背 — Returned Traveler Fever 第䞀順䜍 = Malaria

→ Smear × 3 (q12h) — 即䜿前次 negative 也芁 repeat

130.2.0.2 必背 — Malaria 各 species

Species 區域 特點
P. falciparum Africa, SE Asia Severe (cerebral, ARDS, AKI, hypoglycemia, ARDS); 24-48 hr lethal
P. vivax Asia, S. America Hypnozoites → relapse months later (need primaquine radical cure)
P. ovale W. Africa Hypnozoites — same as vivax
P. malariae Worldwide 72-hr fever cycle; chronic asymptomatic
P. knowlesi SE Asia (Borneo, Malaysia) Zoonotic from macaques; can be severe

130.2.0.3 必背 — Severe Malaria Treatment

  • IV Artesunate (2.4 mg/kg at 0, 12, 24 hr, then daily) — ALL countries first-line for severe (replaced quinine)
  • Adjunctive: glucose monitoring, fluid (cautious), exchange transfusion if parasitemia > 10%
  • After artesunate: full ACT (artemisinin-based combination) course oral