| Severe
Falciparum Malaria |
| Severe,
life-threatening malaria is nearly always caused by P. falciparum.
The following conditions have been proposed as manifestations
of severe falciparum malaria by a working group convened by
the World Health Organization (WHO). |
| I.
Cerebral malaria |
- Coma
- Convulsions
- Severe anaemia (particularly in children)
- Muscle tone may be increased or decreased
- Fever
- Jaundice (adults)
- Enlarged liver and spleen
- Muscle tone may be increased, decreased or normal
- Retinal haemorrhage on ophthalmoscopy
Untreated cerebral malaria is probably uniformly fatal. Overall
mortality in treated cerebral malaria in reported studies
averages 15% in children and 20% in adults (but upto 50% in
pregnancy).
|
| II.
Hypoglycaemia |
- May be asymptomatic .
- May present as further deterioration in the level of
coma.
|
| III.
Pulmonary oedema |
- Hyperventilation (respiratory distress)
|
| IV.
Acute renal failure |
- Common complication of malaria in adults living in areas
of low or unstable transmission.
- Oliguria or polyuria
- Jaundice
- Bleeding tendency
|
| V.
Metabolic acidosis |
- Hyperventilation with increased inspiratory effort
- Hypotension
|
| Blackwater
fever |
Blackwater
fever is a condition where:
- After several bouts of falciparum malaria, particularly
if there has been inadequate treatment, there is occasionally
an abrupt onset of massive intravascular hemolysis with
fever, chills, and prostration.
- The hemoglobin escapes into the urine turning it black
if the urine is acidic
|
| Algid
malaria |
Algid
malaria is a malarial condition where:
- There may be subnormal temperature, weakness, prostration,
feeling of cold, vomiting, rapid respiration and oliguria.
- Death may occur but the patient is conscious till the
end.
- It could be due to adrenal crisis, absorption of endotoxin
from the gut or cachectin-tumor necrosis factor from endotoxin
activated macrophages.
|
