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==History==
==History==
Obtaining a detailed history of the [[symptoms]] and travel history of the patient is an important step for the diagnosis of malaria. A travel history to a country where malaria is endemic, when in the presence of flu-like symptoms is an important alert for the diagnosis.
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The malaria incubation period after an infective mosquito bite includes the time required for the parasites to progress through liver schizogony and produce symptoms by their propagation in the bloodstream. For primary attacks, this period is typically about 8 to 25 days but may be much longer depending on the immune status of the infected person, the strain as well as the species of Plasmodium, the dose of sporozoites, and the possible effects of partially effective chemoprophylaxis. Relapses from latent hypnozoites may develop months or years after mosquito bites. Late-onset or recrudescent P. falciparum malaria may also occur in individuals who have suppressed parasitemia of drug-resistant parasites with chemoprophylactic drugs367 (see Fig. 275-2). Febrile patients presenting within 7 days of entering an endemic area are unlikely to have malaria, unless there has been earlier exposure to infective mosquito bites. As a general rule, and because of the dangers of acute P. falciparum infection, all travelers who have visited a malaria-endemic area in the 3 months prior to onset of fever or other suggestive symptoms should be considered to have malaria until proven otherwise. Even in patients beyond this time frame, it is wise to consider P. falciparum malaria, as illustrated, for example, in the recent report of a symptomatic presentation in an 18-year-old patient with sickle cell disease 4 years after visiting an endemic area.248 Latent attacks from the reactivation of P. vivax or P. ovale hypnozoites usually occur within 3 years and are rare more than 5 years after expo- sure. Recrudescence of P. malariae symptoms in individuals with subclinical parasitemia has been reported decades after initial infection.170,368,369
The malaria incubation period after an infective mosquito bite includes the time required for the parasites to progress through liver schizogony and produce symptoms by their propagation in the bloodstream. For primary attacks, this period is typically about 8 to 25 days but may be much longer depending on the immune status of the infected person, the strain as well as the species of Plasmodium, the dose of sporozoites, and the possible effects of partially effective chemoprophylaxis. Relapses from latent hypnozoites may develop months or years after mosquito bites. Late-onset or recrudescent P. falciparum malaria may also occur in individuals who have suppressed parasitemia of drug-resistant parasites with chemoprophylactic drugs367 (see Fig. 275-2). Febrile patients presenting within 7 days of entering an endemic area are unlikely to have malaria, unless there has been earlier exposure to infective mosquito bites. As a general rule, and because of the dangers of acute P. falciparum infection, all travelers who have visited a malaria-endemic area in the 3 months prior to onset of fever or other suggestive symptoms should be considered to have malaria until proven otherwise. Even in patients beyond this time frame, it is wise to consider P. falciparum malaria, as illustrated, for example, in the recent report of a symptomatic presentation in an 18-year-old patient with sickle cell disease 4 years after visiting an endemic area.248 Latent attacks from the reactivation of P. vivax or P. ovale hypnozoites usually occur within 3 years and are rare more than 5 years after expo- sure. Recrudescence of P. malariae symptoms in individuals with subclinical parasitemia has been reported decades after initial infection.170,368,369
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Revision as of 15:52, 24 July 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];

Overview

Malaria parasites are transmitted by female Anopheles mosquitoes. The parasites multiply within red blood cells, causing symptoms that include symptoms of anemia (light headedness, shortness of breath, tachycardia etc.), as well as other general symptoms such as fever, chills, nausea, flu-like illness, and in severe cases, coma and death.


History

Obtaining a detailed history of the symptoms and travel history of the patient is an important step for the diagnosis of malaria. A travel history to a country where malaria is endemic, when in the presence of flu-like symptoms is an important alert for the diagnosis.


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