Rural Emergency Medicine


This is part of the Med in Small Doses series, which aims to give you a snapshot of a disease or disorder. For information about the series, or common abbreviations click here.

Anopheles mosquito infect humans with plasmodium.

PATHO: Mosquito → skin → liver → blood stream (merozoites) → attack RBCs → use haemoglobin → rupture cell → cycle continues

Types:
  • P Vivax,
  • P.Ovale,
  • P.Malariae,
  • P.Flaciparum (worse type)
    • Infect RBC of any age
    • Resetting & sequestration
    • ↑ cytokine production
 

CFs: Fever, fatigue, jaundice, headache, muscle pain, vomiting, bloody stools
Severe Malaria: cerebral, severe anaemia, respiratory & renal failure.




Complications: CHAPLIN
C erebral Malaria/Coma
H ypoglycaemia
A naemia
P ulmonary Odema
L actic Acidosis
I nfections
N ecrosis of Renal Tubules

Dx: well stained blood smear, ELIZA, PCR

Px: ↓ mosquito exposure, chemoprophalaxis (doxycycline, atovaquone+proguanil tablets), vaccine (in development)

Rx: Mefloquine cures 90 to 95% of P. falciparum malaria.
  • Quinines, doxycycline – blood schizonticides
  • Primaquine & Tafenoquine – tissue schizonticides

Checkout a Guide to Tropical Disease for some 
epidemiology information on Malaria and other diseases.

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