Malaria Flashcards
What is malaria?
Systemic protozoal infection
What causes malaria in humans?
- P. falciparum
- P. vivax
- P. ovale
- P. malariae
P = plasmodium
Describe the transmission of malaria?
- Transmitted through mosquito bite
- Present in the tropics and subtropics
- Mostly P. Falciparum
Describe the pathology of malaria?
- RBCs infected with malaria are prone to haemolysis
- Formation of knob proteins
- Rosettes and rouleaux of uninfected RBCs
Clinical features of malaria?
- Malaise, headache, vomiting
- Anaemia, jaundice
- Hepatosplenomegaly
Effects of malaria in pregnancy?
- Immunity is impaired
- Maternal side of placenta is infected causing:
- Abortion
- Growth retardation
Name some severe complications of falciparum malaria?
- Coma (cerebral malaria)
- Hyperpyrexia
- Convulsions
Describe the management of cerebral malaria as a complication of falciparum malaria?
- Maintain airway
- Avoid glucocorticoids, heparin and adrenaline
- Intubate if necessary
Describe Vivax and Ovale malaria?
- Prodrome fever, rigors
- Flushes
- Hepatosplenomegaly
- Anaemia develops
Describe Malariae and Knowlesi malaria?
- Mild symptoms and intermittent fever
- Parasitaemia persists for years
- Chronic P. Malariae => glomerulonephritis
Which malaria sub-species causes sever disease or death?
Falciparum
Read the case history presentation for malaria
Name some risk factors for malaria infection?
- Pregnancy
- Travel to endemic areas
- Inadequate chemoprophylaxis
- Settled migrants returning to endemic area of origin
Describe the diagnostic tests to perform for someone with suspected malaria infection?
- Giemsa-stained thick and thin blood smears
- Rapid diagnostic tests
- FBC, clotting, U&Es, LFTs
Differential diagnoses for malaria infection?
- Dengue fever
- Headache and retrobulbar pain that worsens with eye movements
- PCR may detect dengue virus early in infection
- Zika virus infection
- Maculopapular, pruritic rash
- Serology positive for Zika virus
What is different about the treatment for P. falciparum malaria?
- It has developed resistance to:
- Chloroquine
- Sulfadoxine-pyrimethamine
Treatment for mild falciparum malaria?
- Co-artemether
- (should be avoided in early pregnancy)
- OR Quinine
Treatment for severe falciparum malaria?
Artesunate
Treatment for non-falciparum malaria?
Chloroquine + Primaquine
Name 2 conditions which protect patients from malaria?
- Sickle cell disease
- G6PD deficiency
What is a characteristic feature of plasmodium ovale malariae?
Cyclical fever every 48 hours
what is the most common non-falciparum cause of malaria?
Plasmodium vivax
