Cryptic/sporadic malaria is rare in the United States. We describe a patient who developed malaria in New York City without any known contact with, or travel to, a malaria-endemic area. The patient presented with symptoms of gastroenteritis. Later, she developed hemolysis and hepatosplenomegaly, and Plasmodium falciparum was found in blood smears. Possible sources of malaria could be an indigenous infected mosquito or a transported infected mosquito from a local international airport.

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