Signs and Symptoms
After a mosquito bite, the parasite goes to the liver where it multiplies and matures through different forms.
After 10 to 35 days, the parasites get released in blood in waves and cause fever. Falciparum incubation period is 10 to 14 days.
Fever may be > 40 0 . It comes on alternate days in P vivax and falciparum and every 3rd day in P ovale. However, if many mosquitoes have bitten laden with parasites, fever may come daily and sometimes many times in a day.
There are typically 3 stages. Stage of chills and shivering, the bed might shake if it is pronounced, stage of warmth and finally sweating before temperature settles down. The patient may feel well in between the fever episodes.
Red blood cells release hemoglobin and anemia ensues. The spleen enlarges in most cases. Untreated fever may continue for weeks and then subside as the body develops immunity or recur again and again over months and at times years.
Malaria can be complicated, often in falciparum variety but sometimes in vivax as well. Complications can involve liver, kidney, brain, heart, lungs, intestines etc. There may be bleeding from various sites, glucose in blood may decline and patients without treatment often die of these complications.
It can cause Coma or unconsciousness, fits, jaundice, kidney failure, bleeding from various sites (DIC), loose motions with low BP and shock (algid malaria). Abortions may occur if patient is pregnant.
Diagnosis is made by peripheral smear examination. A drop of blood is spread (smeared ) on a slide and seen under a microscope after staining. Parasites may be seen and their no can inform us about the severity of infections. Trained and sincere laboratory technicians are required for this test.
Easier tests include looking for malarial parasite antigen and antibodies. These nowadays are quite accurate.
Blood and urine tests are also done for associated complications if any.
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