Hepatitis viruses Leishmaniasis Leptospirosis Malaria disseminated other arboviruses in intravascular coagulation the same class) Serology testing Serology testing Acute hepatitis A and B: supportive Chronic hepatitis C: Ledipasvir, sofosub specific antiviral agents, +/– ribavirin Direct visualization of Visualization of Consultation with CDC should be perfor protozoa from bone protozoa from bone Standard treatment involves pentavalent marrow aspirate marrow or splenic sodium stibogluconate; miltefosine an aspiration Serology if other diagnostic also been used tests unavailable Serology not useful for cutaneous form Ancillary for visceral form: marrow suppression, elevated hepatic transaminases, hypoalbuminemia, hypergammaglobulinemia PCR, culture, or PCR is sensitive and Penicillin or ampicillin for severe diseas immunohistochemical continues to be Doxycycline or amoxicillin for mild dise staining (culture is positive even after also recommended for prophylaxis sensitive and slow) initiation of therapy Need to monitor for Jarisch–Herxheimer Ancillary: can see Serology (microscopic initiation of therapy lymphocytic agglutination test, cerebrospinal fluid MAT) pleocytosis with elevated If sending blood protein and opening cultures, need to pressure; elevated hepatic notify laboratory to transaminases and hold culture for 2–4 bilirubin; urinalysis mo showing pyuria, proteinuria, and hematuria; elevated creatinine, creatine kinase, and amylase Thick, thin smear Thick smear: quantify Check CDC site for regions level of parasitemia (https://www.cdc.gov/malaria/traveler Anemia, thrombocytopenia, ) where parasites retain chloroquine su hypoglycemia, metabolic Thin smear: allows for acidosis, elevated speciation; presence P falciparum: creatinine, bilirubin, and of >1 ring form in a Atovaquone/Proguanil (Malarone) × d serum transaminases erythrocyte suggests Artemether-lumefantrine (Coartem) × Obtain type and screen P falciparum, the Quinine + (clindamycin or doxycycline) and G6PD level (need to species responsible Mefloquine (Larium) × doses know status before for most deaths Severe/complicated malaria: quinine + c treating with primaquine globally exchange transfusion considered for c for the hypnozoite form high-grade parasitemia seen in P vivax and ovale For vivax/ovale: atovaquone Proguanil ) If strongly suspect malaria, not withhold treatment if initial smears negative, simply repeat smears in 12–24 hrs