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Plasmodium Falciparam
Plasmodium Vivax
Plasmodium oval
Plasmodium Malariae
Four species of the genus Plasmodium cause nearly all malarial infections in humans .These are P. falciparum, P. vivax, P. ovale, and P. malariae . Almost all deaths are caused by falciparum malaria.
Human infection begins when a female anopheline mosquito inoculates plasmodial sporozoites from its salivary gland during a blood meal . These microscopic malarial parasites are carried rapidly via the bloodstream to the liver, where they invade hepatic parenchymal cells and begin a period of asexual reproduction.
By this amplification process a single sporozoite eventually may produce from 10,000 to >30,000 daughter merozoites. The swollen infected liver cell eventually bursts, discharging motile merozoites into the bloodstream. These then invade the red blood cells (RBCs) and multiply six- to twentyfold every 4872 h. When the parasites reach densities of ~50/L of blood, the symptomatic stage of the infection begins. immediately but remain dormant for a period ranging from 3 weeks to a year or longer before reproduction begins. These dormant forms, or hypnozoites, are the cause of the relapses that characterize infection with these two species.
In P. vivax and P. ovale infections, a proportion of the intrahepatic forms do not divide
Malignant Malaria
Falciparum Malaria is called as Malignant Malaria due to its potential
To produce more merozoites in
Cerebral
Pulmonary Edema
Hypoglycemia
Several days of prodromal symptoms such as malaise, headache, myalgia , anorexia, and mild fever are interrupted by the first paroxysm. Suddenly the patient feels inexplicably cold (in a hot climate) and apprehensive. Mild shivering quickly turns into violent shaking with teethchattering.
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Cerebral Malaria
Coma
Anuria
Shock
Agitation
Cerebral Malaria
Hematology
Leukocytosis (>12,000/L) Severe anemia (PCV <15%) Coagulopathy Decreased platelet count (<50,000/L) Prolonged prothrombin time (>3 s) Prolonged partial thromboplastin time Decreased fibrinogen (<200 mg/dL) Parasitology Hyperparasitemia Increased mortality at >100,000/L High mortality at >500,000/L
Malaria
Treatmen
Uncomplicated Malaria
Infections due to Plasmodium vivax , Plasmodium malariae , and Plasmodium ovale should be treated with oral chloroquine (total dose,10- 25 mg of base/kg). .
Chronic Malaria
Tropical Splenomegaly
Primaquine
+ Chloroquine
Combination therapy
In much of the tropics, drugresistant P. falciparum has been increasing . It is now accepted that, to prevent resistance, falciparum malaria should be treated with drug combinations and not with single drugs in endemic areas; the same rationale has been applied successfully to the treatment of tuberculosis and HIV/AIDS. Artemisinin combination regimens now constitute first-line recommended treatment for falciparum malaria.
Artemisinin
Falciparum
Quinine
Prevention
Eradication of malaria. Health Education Self Protection Chemoprophylaxis