A 41-year-old man with fever and dark-coloured urine.

A 41-year-old Japanese male who regularly travelled to Sierra Leone for business developed fever and malaise 1 day after returning from a 1-month-long trip there. He was diagnosed with falciparum malaria (with 0.6% parasitaemia) and was administered artemether–lumefantrine for 3 days. His initial admission was uncomplicated. Fourteen days after completing the anti-malarial treatment, he again presented to our hospital, this time complaining of dark-coloured urine (for the first time), malaise and fever. Other than the malaria, he had no remarkable medical history. His …