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
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
