| How
different patients of malaria look when they are first seen |
Initially
symptoms resemble those of a minor viral illness. These include:
- Lack of sense of well being
- Headache
- Fatigue
- Abdominal discomfort
- Muscle aches followed by fever
- Nausea/ vomiting
These may be followed by typical malaria picture:
- Fever spikes (sudden rise and fall in temperature)
- Chills
- Rigors
|
| Cold
stage |
| As the
temperature begins to rise, there is intense headache and muscular
discomfort. The patient feels cold, clutches blankets, and curls
up shivering and uncommunicative. (The chill) . Within minutes
the limbs begin to shake and teeth chatter, and the temperature
climbs rapidly to a peak. The rigor usually lasts 10-30 minutes
but can last upto 90 minutes. |
| Hot
stage |
| By the
end of rigor there is peripheral vasodilatation and the skin
feels hot and dry. The temperature is high. |
| Sweating |
| Profuse
sweat then breaks out. It lasts for 2-4 hours. The patient is
soaked in sweat and the temp falls. The blood pressure is relatively
low. The patient feels exhausted and may sleep. Defervescence
usually takes 4-8 hours. Fever is irregular at first with temperature
exceeding 39 degrees centigrade. It may rise upto 40oC. |
| Incubation
time |
| The time
interval between mosquito bite and development of malaria is
13-14 days except for P. malariae (35 days) |
| If
the infection is left untreated |
- Fever recurs every third day in P.vivax and ovale infection
establishing a 2-day cycle (tertian)
- Spike occurs every three days (Quartan) in P.malariae
infection i.e. fever recurs every fourth day
- The pattern of fever in P. falciparum infection is erratic
- Paroxysms with rigors are more common in P. vivax &
P. ovale than in P. falciparum and P. malariae malaria.
True rigors are unusual in naturally acquired falciparum
malaria.
- As the infection continues the spleen and liver enlarge
and anemia develops. The patient loses weight. If no treatment
is given the natural infection stabilizes for several weeks
or months and then gradually resolves.
|
| Associated
Symptoms |
- Mild abdominal discomfort
- Constipation
- Diarrhoea
- Children are irritable, have less appetite
|
| Malaria
in Pregnancy |
There
is increased risk of severe Falciparum malaria in the second
and third trimester of pregnancy.
- In areas of less transmission, it is an important cause
of fetal death and results in high maternal mortality.
- In areas of intense transmission, it may be associated
with low birth weight. The infected mothers may be asymptomatic.
|
| Malaria
in children |
The majority
of childhood malarial infections present with fever and malaise.
In addition to the clinical features mentioned for adults malaria
in children may lead to -
- Convulsions
- Coma
- Hypoglycaemia
- Metabolic acidosis
- Severe anaemia
|
