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A Near-Death Mistake

Tropical malaria, or plasmodium falciparum, is the only lethal variety of the four types of malaria.

The raging thirst was the worst. It was all the more agonizing because I was nauseated to the point that I could only sip delicately from the sweet, refreshing pitcher of water on my hospital nightstand in Germany. I wanted so badly to chug the whole thing, but my stomach twitched involuntarily at the prospect.

For six days my temperature had hovered at 40° Celsius. Try doing long division in your head when you're loopy with fever… multiply by 1.8 then add 32. It works out to 104° Fahrenheit.
I initially thought it was just the worst flu I'd ever had. I waited three sweat-drenched, fever-wracked days before my wife Darlene insisted that we ask the hotel to call a doctor. Yes, German doctors still make house calls.

His diagnosis was either influenza or, in light of the fact that I had just returned from Africa, malaria. He wrote directions to Nurnberg's Klinik Nord hospital and told me to take a taxi immediately.

I had not taken the anti-malarial prophylaxis prior to leaving for Cameroon because we would be hunting the northern savanna where it's hot and dry and loaded with tsetse fly—but no mosquitoes. I hadn't counted on Air Cameroon's quixotic scheduling, which had necessitated a two-night layover in the country's sweltering port city of Douala on our outbound to the U.S., via Nurnberg, Germany, site of the famous IWA hunting and shooting show.

Now I lay in a puddle of my sweat, utterly miserable. My white blood cell count was dangerously low, but not nearly as life-threatening as my plummeting platelets. A normal platelet count is between 150 and 450; when I was admitted, the platelets had dropped to 50; the next morning, 23, and the next, 21.

"Anything below 20 is life-threatening," cautioned Dr. Grummich, my attending physician and a specialist in tropical diseases. "This is no joking matter. Tropical malaria is the leading cause of death in Africa."

Tropical malaria, or plasmodium falciparum, is the only lethal variety of the four types of malaria. Malaria is a parasitic protozoa that attacks red blood cells. If it gets into the brain, cerebral malaria results, which is usually fatal. About two percent of falciparum victims die and there are estimated to be 500 million cases a year.

After the sweats came the shakes, then the headaches. There was blood in my urine and a constant drone in my ears, like a 747 at take-off thrust. Ultrasound tests showed my liver and spleen were swollen and enlarged.

Seven days later, I was released from the hospital, weak and a bit tottery, but alive. As I thanked Dr. Grummich for his wonderful care and compassionate bedside manner, I allowed that I had learned a big lesson: always take malarial prophylaxis.

He smiled but shook his head sternly. "That is not the lesson," he admonished.

"The lesson is that if you have such a high fever after leaving Africa, don't wait three days to see a doctor. It might be Dengue fever, it might be tropical malaria, it be influenza, but don't wait. The delay could have killed you."

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