INFECTIOUS DISEASE
MALARIA (PLASMODIUM FALCIPARUM)
Infectious disease due to the presence of the parasitic protozoa of the genus plasmodium within the red blood cells. The disease is transmitted by the anopheles mosquito in tropical/subtropical areas - oxford
PromptDiagnosis
ResponseBlood flims - Thin + thick. Typically need 3 or more films. Negative does not exclude. Gives diagnosis and parasite load,
(3 consecutive days or 2 simultaneously if high concern)
Thick film - is there malaria
Thin film - species identification
Antigen test - Rapid but qualitative. Simple use in the field, no lab required.
(3 consecutive days or 2 simultaneously if high concern)
Thick film - is there malaria
Thin film - species identification
Antigen test - Rapid but qualitative. Simple use in the field, no lab required.
PromptTypes of Plasmodium
ResponseFalciparum - The worst - systemic disease, badness
Vivax - less severe but can relapse up to 1 yr
Ovale - less severe but can relapse up to 1 yr
Malariae
Vivax - less severe but can relapse up to 1 yr
Ovale - less severe but can relapse up to 1 yr
Malariae
PromptTreatment of Plasmodium Falciparum
ResponseArtesunate 2.4mg/kg IV then PO (Best - works on all stages of disease, avoid preg and G6PD)
Quinine 20 mg/kg IV over 4h (there are some quinine resistant strains)
Supportive care
Notifiable disease
Quinine 20 mg/kg IV over 4h (there are some quinine resistant strains)
Supportive care
Notifiable disease
PromptPlasmodium falciparum differences vs other plasmodia
ResponsePlasmodium Falciparum has:
No hypnozoite phase - has relapse phase
High percentage of parasitaemia compared to others
High resistance to chloroquine
More severe disease and major complications (cerebral malaria, ARF), and has higher mortality
No hypnozoite phase - has relapse phase
High percentage of parasitaemia compared to others
High resistance to chloroquine
More severe disease and major complications (cerebral malaria, ARF), and has higher mortality
PromptComplications in P. Falciparum
ResponseCerebral malaria
Resp failure (ARDS like) - non cardiogenic pulmonary oedema
ATN/AKI
Hypoglycaemia
Haemolysis/anaemia >> dark urine “Blackwater fever” (Piss is black)
Splenomegaly/rupture
Lactic acidosis
Resp failure (ARDS like) - non cardiogenic pulmonary oedema
ATN/AKI
Hypoglycaemia
Haemolysis/anaemia >> dark urine “Blackwater fever” (Piss is black)
Splenomegaly/rupture
Lactic acidosis