Malaria usually begins with nonspecific symptoms which could easily be ascribed to other common febrile illnesses and hence be missed. If left untreated, it can lead to severe complicated malaria and death. We describe a case of a 43-year-old male patient with fever who recently returned from West Africa. Initially he was treated for pneumonia; however, after 4 days his symptoms deteriorated and he was diagnosed with severe complicated falciparum malaria for which he was admitted to the ICU. We advocate prompt exclusion of malaria in every patient presenting with fever in the three months following return from an endemic region, and remaining vigilant for an extended period.
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