A 7-year-old child from West Bengal presented with high grade fever with chills and rigor. Peripheral smear examination revealed Plasmodium vivax. He was given treatment for the same. But he again presented with jaundice, and a repeat peripheral smear showed following. What is your diagnosis?
## **Core Concept**
The question revolves around a case of malaria caused by *Plasmodium vivax* in a 7-year-old child, who after initial treatment, presents again with jaundice and a different finding on the peripheral smear. This scenario suggests a complication or a different condition related to the initial malaria treatment or a secondary infection.
## **Why the Correct Answer is Right**
The correct answer, , indicates a diagnosis of Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency. G6PD deficiency is a genetic disorder that occurs mostly in males, leading to an enzyme deficiency that makes red blood cells more susceptible to hemolysis under certain conditions, such as infections or exposure to certain drugs. The child was likely given primaquine, a common drug used to treat *P. vivax* malaria, which can trigger hemolysis in individuals with G6PD deficiency. The presentation with jaundice and the specific findings on the peripheral smear (not explicitly described but implied to be related to hemolysis) point towards this diagnosis.
## **Why Each Wrong Option is Incorrect**
- **Option A:** This option is incorrect because it does not directly relate to a condition that would cause jaundice and be associated with the treatment of malaria or a complication thereof.
- **Option B:** This option does not provide enough information to assess its relevance directly, but given the context, it seems less likely to be related to the scenario described.
- **Option D:** This option is incorrect as it does not align with the clinical presentation of jaundice following malaria treatment and the implication of a condition affecting red blood cells.
## **Clinical Pearl / High-Yield Fact**
A crucial point to remember is that primaquine can cause hemolysis in patients with G6PD deficiency. Therefore, before administering primaquine for *P. vivax* malaria, it is essential to screen for G6PD deficiency, especially in regions where the deficiency is prevalent, such as West Bengal.
## **Correct Answer:** .