Moses is a 38 year-old man who complains of

'Hotness of body', nausea, vomiting and Global headache for the past two days. He was treated for malaria 6 months ago, but was 'cured'. Vital signs: Temp = 38.2°C, Pulse = 106, BP = 110/70, Resp =20

• Physical exam:
• Moses is in no apparent distress, oriented as to place and time.
• Pupils are equal although conjunctiva are very pale.
• Neurological exam shows no deficits or localizing signs.
• Oral exam is unremarkable; there is no thrush.
• Cardiac exam reveals tachycardia with a 2/6 systolic ejection murmur at the right sternal border. Lungs are clear bilaterally.
• Abdomen is soft with no tenderness, there is mild splenomegaly.
• Extremities show no edema and there are good pulses.

Moses is started on IV quinine and admitted.