A search of the existing literature did not identify any previously reported cases of acute abdomen as atypical features of vivax malaria. The case presented here illustrates the ubiquitous nature of this disease with its unusual clinical manifestations in the UK.

A 51-year-old Asian man presented to the acute surgical admissions unit with a 1 week history of left iliac fossa pain, malaise and non-bilious vomiting. No other bowel or urinary symptoms were present. His medical history included asthma, which was well controlled with inhalers. He had no history of any previous abdominal surgery.

On examination, he was found to be clammy and to have dry mucosal surfaces. Initial observations recorded a temperature of 40.1°C and a regular pulse of 133 …