# Unsuspected Malaria Diagnosed on a Routine Peripheral Smear Review

## TL;DR

A man with fever and dark urine was found to have malaria after a routine blood test revealed Plasmodium vivax, highlighting the importance of travel history and timely diagnosis.

## Contribution

This case highlights the diagnostic value of routine peripheral smear reviews in identifying unsuspected malaria.

## Key findings

- Plasmodium vivax was identified incidentally on a peripheral smear after travel history was obtained.
- The case emphasizes the need for thorough travel history assessment in patients with unexplained symptoms.
- Timely laboratory investigation confirmed the diagnosis and guided appropriate management.

## Abstract

Prompt diagnosis of malaria infection is critical for effective management, yet it can be challenging due to varying incubation periods and the need for physician-initiated laboratory workups. We present a case of a 40-year-old male with fever and dark-colored urine, initially evaluated for sepsis. Plasmodium vivax was incidentally identified on a peripheral smear review after obtaining a remote travel history from a malaria-endemic area. Consultation with the Centers for Disease Control confirmed the diagnosis, emphasizing the importance of thorough travel history assessment and timely laboratory investigation in suspected cases of malaria. This case underscores the significance of early diagnosis in managing this potentially life-threatening infection.