Rarely a patient with malaria may develop a leukemoid reaction.
Patient selection: malaria
Features:
(1) marked leukocytosis with left shift seen in the blood smear
(2) variable thrombocytosis
(3) parasitemia
(4) severe anemia
In some patients there is a concurrent bacterial infection, most often to a Gram-negative bacteria. It is important to work the patient up for sepsis, urinary tract infection and other infections.
If the workup for infection is negative and if the leukemoid reaction reverses on antimalarials then the leukemoid reaction can be presumed to be due to malaria.
It is important to exclude a concomitant leukemia.
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