Malaria Flashcards
What kinds of plasmids cause latent malaria?
P. vivax
P. Ovale
What is the most deadly malaria causing plasmid?
P. falciparum
How can some malaria become dormant?
Once in the blood stream and eventually liver, sporozoites enter liver cells
They will either become dormant hypnozoites or schizonts that rupture and enter RBC
What are the symptoms of malaria?
Cyclic fever (tertian or quartan pattern)
malaise
headache
Rigors
diaphoresis
*usually occur ~2 weeks after infection
What are some severe clinical presentations of malaria?
Cerebral malaria = CNS
Respiratory failure
Acute renal failure
Hematopoietic system (severe anaemia)
What is the prophylaxis for chloroquine-sus malaria?
Chloroquine = 1wk before entry, 4 wks after leaving
What is the prophylaxis for chloroquine resistant malaria areas?
Atovaquone + proguanil = shortest treatment period, can cause psychiatric ADRs
Doxycycline (sun sensitivity) = compliance issue
Mefloquine = compliance issue
What is used to treat uncomplicated malaria?
1) Artemether + lumefantrine
2) Atovagquone + proguanil
3)Quinine sulfate + doxycycline or clindamycin
Will normal treatments eliminate dormant malaria?
No, dormant hypnozoites require concurrent treatment with primaquine
What is a consideration for primaquine use?
Can cause severe haemolysis in those who are deficient in glucose-6-phosphate dehydrogenase (G6PD)
How is severe malaria treated?
Require IV treatment
- Artesunate = emerging resistance
- Quinine dihydrochloride (monitor BP, BG, cardiac monitoring)
When is urgent treatment of malaria necessary?
Any degree of altered consciousness, jaundice, oliguria, resp distress, severe anaemia, or hypoglycaemia
parasite count >100,000/mm3
vomiting
clinical acidosis or metabolic acidosis
acute kidney injury
