The hallmark of malaria is febrile paroxysms, patients present with profound rigor, headache, aches, nausea, back pain, and sometimes abdominal pain. After 3 to 6 hours, the patient defervesces, often with profuse sweating. There may be liver and spleen enlargement and, splenic rupture. Rarer presentations are jaundice, urticaria, and petechiae.
Delirium is common.
With cerebral malaria, there is depression of consciousness, disorientation, hallucinations, behavioral changes, and occasionally meningismus, seizures, focal signs or coma.