- Protozoan infection transmitted through the Anopheles mosquito
- Incubation period 8–16 d
- Periodicity of the disease is due to the life cycle of the protozoan:
- Exoerythrocytic phase: Immature sporozoites migrate to liver, where they rapidly multiply into mature parasites (merozoites)
- Erythrocytic phase: Mature parasites are released into circulation and invade RBCs
- Replication within RBCs followed 48–72 hr later by RBC lysis and release of merozoites into circulation, repeating cycle
- Fever corresponds to RBC lysis
- Plasmodium falciparum:
- Cause of most cases and almost all deaths
- Usually presents as an acute, overwhelming infection
- Able to infect red cells of all ages:
- Results in greater degree of hemolysis and anemia
- Causes widespread capillary obstruction:
- Results in end-organ hypoxia and dysfunction
- More moderate infection in people who are on or who have recently stopped prophylaxis with an agent to which the P. falciparum is resistant
- Post-traumatic immunosuppression may cause relapse of malaria in patients who have lived in endemic areas
- Plasmodium vivax and Plasmodium ovale:
- May present with an acute febrile illness
- Dormant liver stages (hypnozoites) that may cause relapse 6–11 mo after initial infection
- Plasmodium malariae:
- May persist in the bloodstream at low levels up to 30 yr
- Transmission usually occurs from the bite of infected female Anopheles mosquito
- North American transmission possible:
- Anopheles mosquitoes on east and west coasts of the U.S.
- Transmission may also occur through infected blood products and shared needles
- Sickle cell trait protective
- Cerebral malaria more common in children
- In highly endemic areas with minimal lab capability, all children presenting with febrile illness may be treated
Pregnant patients, especially primigravida, at higher risk
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Schaider, Jeffrey J., et al., editors. "Malaria." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307115/all/Malaria.
Malaria. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307115/all/Malaria. Accessed May 31, 2023.
Malaria. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307115/all/Malaria
Malaria [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2023 May 31]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307115/all/Malaria.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Malaria ID - 307115 ED - Barkin,Adam Z, ED - Shayne,Philip, ED - Rosen,Peter, ED - Schaider,Jeffrey J, ED - Barkin,Roger M, ED - Hayden,Stephen R, ED - Wolfe,Richard E, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307115/all/Malaria PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -