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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.<ref>{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref>
A travel history in the previous three months to a country where malaria is endemic, when in the presence of [[fever]] and flu-like symptoms is an important alert for the diagnosis.<ref>{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref>


After the mosquito bite, the typical incubation period of malaria may range from 8 to 25 days, in a primary attack. This period may be longer, depending on the status of the immune system of the host, the species and strain of the parasite, the dose of sporozoites, as well as the possible presence of prophylactic drugs. However, in the case of latent hypnozoites, relapses may occur within months to years after the mosquito bite.<ref>{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref>
Following the infective bite by the Anopheles mosquito, a period of time ranging from 7 to 30 days goes by before the first symptoms appear.  


Commonly, the [[diagnosis]] of [[malaria]] should be considered in every patient who presents with an onset of [[fever]] and other related symptoms, who has traveled to a malaria-[[endemic]] region on the previous 3 months. Sometimes a wider time-frame may be considered.<ref>{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref>
===Fever Pattern===
[[Fever]] in [[malaria]] is classically described as occurring in paroxysms of a few hours. These may be described as:
[[Fever]] in [[malaria]] is classically described as occurring in paroxysms of a few hours. These may be described as:
* ''Cold stage'' - where the patient experiences [[rigors]] and [[chills]]
* ''Cold stage'': where the patient experiences [[rigors]] and [[chills]]
* ''Hot stage'' - characterized by [[fever]], [[headaches]], and children may experience [[seizures]]
* ''Hot stage'': characterized by [[fever]], [[headaches]], and children may experience [[seizures]]
* ''Sweating stage'' - characterized by [[sweats]], return to normal temperature with a feeling of [[fatigue]]
* ''Sweating stage'': characterized by [[sweats]], return to normal temperature with a feeling of [[fatigue]]


The time-interval between [[fever]] paroxysms changes according to the type of Plasmodium causing the disease:
The time-interval between [[fever]] paroxysms changes according to the type of [[plasmodium]] causing the disease:
* "Tertian" fever - paroxysms occur every second day, caused by "tertian" parasites:
* "Tertian" fever: paroxysms occur every second day, caused by "tertian" parasites:
:* [[P. falciparum]]
:* [[P. falciparum]]
:* [[P. vivax]]
:* [[P. vivax]]
:* [[P. ovale]]
:* [[P. ovale]]


* "Quartan" fever - paroxysms occur every third day, caused by the "quartan" parasite:
* "Quartan" fever: paroxysms occur every third day, caused by the "quartan" parasite:
:* [[P. malariae]]
:* [[P. malariae]]



Revision as of 22:16, 24 July 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Overview

The hallmark symptom of malaria is fever, which commonly occurs in paroxysms, separated by fever-free time-intervals. The classical but rarely observed malaria attack lasts 6-10 hours, and it consists of a cold stage, hot stage, and sweating stage. Other common symptoms of malaria include chills, headache, weakness, night sweats, flu-like symptoms, and muscle and joint pain. 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.[1]

History

A travel history in the previous three months to a country where malaria is endemic, when in the presence of fever and flu-like symptoms is an important alert for the diagnosis.[2]

Following the infective bite by the Anopheles mosquito, a period of time ranging from 7 to 30 days goes by before the first symptoms appear.

Fever in malaria is classically described as occurring in paroxysms of a few hours. These may be described as:

  • Cold stage: where the patient experiences rigors and chills
  • Hot stage: characterized by fever, headaches, and children may experience seizures
  • Sweating stage: characterized by sweats, return to normal temperature with a feeling of fatigue

The time-interval between fever paroxysms changes according to the type of plasmodium causing the disease:

  • "Tertian" fever: paroxysms occur every second day, caused by "tertian" parasites:
  • "Quartan" fever: paroxysms occur every third day, caused by the "quartan" parasite:

Common Symptoms

Less Common Symptoms

References

  1. Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
  2. Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.

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