- Most dangerous form of malaria – highest number of deaths
- Transmitted by the female Anopheles mosquito (females feed on blood, males feed on nectar)
- Most commonly seen along in Southeast Asia, Latin America, and Africa
- Two phases – liver and RBC phase
- Symptoms:
- Temperature paroxysms (alternating fevers and chills)
- Headache
- Diarrhea
- Jaundice
- Considered severe infection if evidence of end organ damage (Falciparum is sticky and can cause ischemia and infarcts as the RBCs get more viscous!)
- Cerebral malaria – ischemia/infarcts in the brain
- ARDS
- Nephropathy
- Hypotension
- Physical exam findings:
- Hepatomegaly (from the parasite replicating in the liver)
- Splenomegaly (from the spleen taking up the damaged RBCs)
- Pallor
- Jaundice and scleral icterus
- Diagnosis:
- Thick and thin smears
- Thick smears give a look at the RBCs in an overall sense to figure out if a parasite is present – are there parasites? If yes, look at thin smear.
- Thin smears give a closer look at the TYPE of parasite – what type of parasite is it?
- Rapid detection test – blood test which looks at enzymes on the various parasites to determine the type – only available at certain hospitals
- Thick and thin smears
- Treatment:
- Start immediately!
- Determined based on the type of plasmodium, whether the malaria is severe or not, and whether the organisms are from an area with high resistance
- Use 2-3 medications for treatment – consult ID immediately once you have a suspicion!
- Prophylaxis
- Given to anyone going to an endemic area – start a few weeks before travel, continue during travel, and continue for some time after returning depending on the medication
- Wear long sleeves and pants
- Use DEET
SCVMC IM Chief Resident Blog 