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Section 3. Summaries of Infectious Diseases
Malaria
Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
CLINICAL MANIFESTATIONS: The classic symptoms of malaria are high fever with chills, rigor, sweats, and headache, which may be paroxysmal. If appropriate treatment is not administered, fever and paroxysms may occur in a cyclic pattern. Depending on the infecting species, fever appears every other or every third day. Other manifestations can include nausea, vomiting, diarrhea, cough, arthralgia, and abdominal and back pain. Anemia and thrombocytopenia are common, and pallor and jaundice caused by hemolysis may occur. Hepatosplenomegaly may be present. More severe disease occurs in people without previous exposure and people who are pregnant or immunocompromised.
Infection with Plasmodium falciparum potentially is fatal and most commonly manifests as a febrile nonspecific influenza-like illness without localizing signs. With more severe disease, P falciparum infection may manifest as one of the following clinical syndromes:
Cerebral malaria, which may have variable neurologic manifestations, including seizures, signs of increased intracranial pressure, confusion, and progression to stupor, coma, and death
Hypoglycemia, sometimes associated with quinine treatment, requiring urgent correction
Noncardiogenic pulmonary edema, which is difficult to manage and may be fatal (rare in children)
Renal failure caused by acute tubular necrosis (rare in children younger than 8 years of age)
Respiratory failure and metabolic acidosis, without pulmonary edema
Severe anemia attributable to high parasitemia and consequent hemolysis
Vascular collapse and shock associated with hypothermia and adrenal insufficiency
Individuals with asplenia who become infected may be at increased risk of more severe illness and death.
Syndromes primarily associated with Plasmodium vivax and Plasmodium ovale infection are as follows:
Anemia attributable to acute parasitemia
Hypersplenism with danger of late splenic rupture
Relapse, for as long as 3 to 5 years after . . . [Go to Full Text]
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