2nd August 2023

A 49 year old woman presents with a 5 day history of fevers, malaise, and myalgia. Today, she has started passing black urine.

A 49 year old woman presents with a 5 day history of fevers, malaise, and myalgia. Today, she has started passing black urine. She recently returned from a holiday to Sudan.

Examination reveals a soft but generally tender abdomen and a temperature of 39.2, which has been fluctuating throughout the day. Blood tests show metabolic acidosis, a stage 2 AKI, and mild anaemia.

What is the investigation of choice to confirm the diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.