THEODORE H. NOEHREN
Periodic chills with fever,1, 2, 3 splenomegaly,4, 5 and anemia6 have been traditionally recognized and taught7, 8, 9 as the diagnostic triad of malaria. Even the most recent publications continue to propagate this dictum.10 Boyd,11 in 1944, states categorically: "Clinically active malaria infections, regardless of the species of their causative parasite, exhibit three basic symptoms: (a) fever, (b) anemia, (c) splenomegaly."
Recent experience with acute malaria cases, however, leads one to believe that the value of the triad in diagnosis of this disease deserves much reconsideration. True, a patient with typical periodic fever, splenomegaly, and anemia is more than likely
NOEHREN TH. THE MALARIA TRIAD1. Ann Intern Med. ;25:293–303. doi: 10.7326/0003-4819-25-2-293
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Published: Ann Intern Med. 1946;25(2):293-303.
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