Department of Haematology, Liaquat National Hospital and Medical College, Karachi, Pakistan.
A 33-year-old man presented with left hypochondrium pain and high-grade fever for 1 week and generalized convulsions followed by persistent unconsciousness. Physical examination revealed pulse, 118 beats/min; blood pressure, 90/60 mmHg; temperature, 38.5℃; Glasgow Coma Scale score, 6/15; and decerebrate rigidity. Complete blood count showed hemoglobin, 8.1 g/dL; total leukocytes, 12.6×109/L; platelets, 13×109/L. Other investigations revealed aspartate transaminase, 119 U/L; alanine transaminase, 76 U/L; total bilirubin, 3.5 mg/dL; indirect bilirubin, 2.8 mg/dL. His coagulation profile showed an international normalized ratio of 2.4, along with severe metabolic acidosis. Contrast-enhanced computed tomography showed diffuse cerebral edema. Leishman's stained peripheral film revealed abundant intraerythrocytic