Min: four paragraphs and four references
What would be the best next step in the clinical management of this case? Have step by step explanation behind this reasoning?
The patient is admitted to the medical intensive care unit and treated with oral quinine and doxycycline. Later that day, the blood smear is reviewed by more experienced personnel for speciation.
An autopsy was performed, but after a delay of 8 days. The gross findings show a slight swelling of the cerebral gyri, with consequent narrowing of the sulci; some blood vessels are engorged, with scattered petechial hemorrhage. The hematoxylin-eosin section of the brain shows autolysis, some pyknotic nuclei, and scattered pigment felt to be malarial in origin. The pigment and pinpoint hemorrhages are felt to be pre-mortem.
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