The Phenomenon of the ‘Starry Sky’ on Blood: Lesson Learned From Severe Malaria Falciparum

Severe malaria occurs when previously uncomplicated malaria infections are then turn to be full blown and tangled by serious, single or multi-organ failures or abnormalities in the patient's blood or metabolism. Clinical deterioration can happen abruptly and unnoticed, due to the masking of other prominent clinical condition like hyperthermia. Making the correct diagnosis as soon as possible is pivotal before administering antimalarial therapy. Diagnosis is made by examining the thick and thin blood films in an attempt to find malaria parasites in the blood sample.The “Starry Sky” appearance is a microscopic feature of severe malaria infection and its exclusively found only in thick blood film. The aim of this minireview is to discuss about the clinical background of “Starry Sky” appearance found in thick blood smear of severe malaria and its brief review combined with our experience in the Deptartment of Parasitology, Faculty of Medicine Universitas Kristen Indonesia, Jakarta-Indonesia, in handled blood test from a vulnerable patient with severe malaria and how we pass on the lessons from that story to our students as part of health communication in community based Parasitology. By inserting this story to our lesson materials, we hope can build awareness among our students as future health practitioners and also to the public they serve as well as all stake holders; this snow ball action  are currently  and continously required to be done.