Blood & Tissue Protozoa: SPOROZOA/APICOMPLEXA
(Plasmodium)
Disease :Malaria is caused by four plasmodia: Plasmodium vivax, Plasmodium ovale, Plasmodium
malariae, and Plasmodium falciparum. P. vivax and P. falciparum are more common causes of malaria than are
P. ovale and P. malariae. Worldwide, malaria is one of the most common infectious diseases and a leading cause
of death.
Important Properties
The vector and definitive host for plasmodia is the female Anopheles mosquito (only the female takes a blood
meal). There are two phases in the life cycle: the sexual cycle , which occurs primarily in mosquitoes is called
sporogony because sporozoites are produced, and the asexual cycle, which occurs in humans, the intermediate
hosts.1 is called schizogony because schizonts are made.
Malaria is transmitted primarily by mosquito bites, but transmission across the placenta, in blood
transfusions, and by intravenous drug abuse also occurs.
Pathogenesis & Epidemiology
Most of the pathologic findings of malaria result from the destruction of red blood cells. Red cells are destroyed
both by the release of the merozoites and by the action of the spleen to first sequester the infected red cells and
then to lyse them. The enlarged spleen characteristic of malaria is due to congestion of sinusoids with
erythrocytes, coupled with hyperplasia of lymphocytes and macrophages.
Malaria caused by P. falciparum is more severe than that caused by other plasmodia. It is characterized by
infection of far more red cells than the other malarial species and by occlusion of the capillaries with aggregates
of parasitized red cells. This leads to life-threatening hemorrhage and necrosis, particularly in the brain (cerebral
malaria). Furthermore, extensive hemolysis and kidney damage occur, with resulting hemoglobinuria. The dark
color of the patient's urine has given rise to the term "blackwater fever." The hemoglobinuria can lead to acute
renal failure.
The timing of the fever cycle is 72 hours for P. malariae and 48 hours for the other plasmodia. Disease caused by
P. malariae is called quartan malaria because it recurs every fourth day, whereas malaria caused by the others is
called tertian malaria because it recurs every third day. Tertian malaria is subdivided into malignant malaria,
caused by P. falciparum, and benign malaria, caused by P. vivax and P. ovale.
Clinical Findings
Malaria presents with abrupt onset of fever and chills, accompanied by headache, myalgias, and arthralgias,
about 2 weeks after the mosquito bite. Fever may be continuous early in the disease; the typical periodic cycle
does not develop for several days after onset. The fever spike, which can reach 41°C, is frequently accompanied
by shaking chills, nausea, vomiting, and abdominal pain. The fever is followed by drenching sweats. Patients
usually feel well between the febrile episodes. Splenomegaly is seen in most patients, and hepatomegaly occurs
in roughly one-third. Anemia is prominent.
Untreated malaria caused by P. falciparum is potentially life-threatening as a result of extensive brain (cerebral
malaria) and kidney (blackwater fever) damage. Malaria caused by the other three plasmodia is usually self-
limited, with a low mortality rate. However, relapses of P. vivax and P. ovale malaria can occur up to several
years after the initial illness as a result of hypnozoites latent in the liver.
The life cycle
ax NOW Malaria RDT Bin
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ciparum [Link]
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Making thin and thick blood films
