Malaria Schizonts

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QUESTION:

What is the difference between schizont of Plasmodium vivax and P. falciparum?

ANSWER:

P. falciparum schizonts tend to fill up to about two-thirds of the host red blood cell, and contain 8-24 merozoites (see image below for development of schizont). However, schizonts of P. falciparum are rarely seen in peripheral blood; instead, multiple, smaller rings are the usual diagnostic sign. Characteristic crescent-shaped gametocytes may also be observed, though usually later on in infection.

 

falciparum schizont CDC

The stages of maturation of a Plasmodium falciparum schizont. Image courtesy of CDC (www.dpd.cdc.gov)

P. vivax schizonts are large and fill up the entirety of the red blood cell with 12-24 merozoites, each containing visible chromatin and cytoplasm (see below). Their size and shape can differentiate them from the more compact P. ovale and P. malariae schizonts, though separating the former can sometimes be difficult.

vivax schizont CDC

The stages of maturation of a Plasmodium vivax schizont. Image courtesy of CDC (www.dpd.cdc.gov)

What is “Pf” and “Pv” in relation to malaria?

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QUESTION:

What is pf and pv?

ANSWER:

“Pf” stands for Plasmodium falciparum and “Pv” stands for Plasmodium vivax. These are two different species of the parasite that causes malaria in humans. Pf causes the most acute, severe form of the disease, which can have a cerebral manifestation (“cerebral malaria”) and causes the most deaths worldwide. Pv is still a serious disease, but usually less severe. If diagnosed early, both forms are easily treated and completely curable.

Treatment for Pregnant Woman with P. Vivax Malaria

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QUESTION:

A pregnant woman has vivax malaria what treatment should be given in case of relapse?

ANSWER:

Primaquine, the usual drug given to prevent relapse of P. vivax malaria, is not recommended for pregnant women due to inadequate information about its safety. As such, it is normally recommended to treat the relapses with chloroquine, to cure each malarial episode, until after delivery of the child, after which time the woman should be treated with primaquine.

high fever after malaria is cured?

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QUESTION:

My dad was infected with malaria,and his blood platelets were depleted to 35000. He was immediately admitted to hospital. Now after 5 days of being admitted, he is getting high fever around 102 degrees every morning and evening. His blood platelets have increased to 3lac and all other reports are normal. According to the doctor, the malaria is cured, but they are not able to detect the reason for periodical high fever…is such fever common after malaria? What might be the reason? Please help.

ANSWER:

One of our collaborating medical doctors has kindly assisted in providing this answer. Fever can be from co-infection with a second strain/type of malaria, or from the drug being used to treat the malaria.  If his platelets were that low, then the likely type of malaria causing the infection would be Plasmodium falciparum, or a particularly heavy P. vivax burden, or infection with both. If he was/is in the hospital, other causes for fever could also be the IV line/another drug being given, complications such as pneumonia from being at bedrest or so ill, cholecystitis from not eating due to illness, DVT or blood clots in legs from immobility….there are many possibilities. More information would be needed to distinguish between these options.

What is malaria?

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QUESTION:

What is malaria?

ANSWER:

Malaria is a disease caused by a parasitic single-celled animal known as Plasmodium. There are different species of Plasmodium, which cause different kinds of malaria. The main types which infect humans are P. falciparum, P. vivax, P. ovale and P. malariae. The parasite is transmitted by certain species of mosquito; the parasite lives in the human blood stream and so goes in to the mosquito when the insect feeds. When the same individual mosquito then feeds on another person, it transmits parasites into a new host.

The symptoms of malaria are caused by the actions that the parasite undertakes while in the human host. For example, part of its reproductive cycle involves invading and then multiplying inside red blood cells. Once several cycles of reproduction have occurred, the new parasites burst out of the red blood cell, destroying it. The cycles are times so that all the new parasites burst out of the red blood cells at the same time; this coordinated destruction of the red blood cells, either every 24, 48 or 72 hours, depending on the malaria species, causes the one day, two day or three day cycles of fevers and chills that characterize malaria infection episodes.

What pathogenic organisms cause malaria?

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QUESTION:

What pathogenic organism causes the disease?

ANSWER:

Malaria is caused by single-celled organisms, called protozoans, of the genus Plasmodium. Different forms of malaria are caused by different species of Plasmodium. The most severe and deadly form is caused by P. falciparum, which is responsible for 90% of the global deaths from malaria, the majority of these in Africa, and mostly in young children. Other species of Plasmodium which commonly infect humans include P. vivax, P. ovale and P. malariae. Recently, a fifth form, P. knowlesi, has been found infecting rural communities in south-east Asia.

The disease is caused when the parasite enters the patient’s red blood cells, reproduces rapidly and then bursts out of the cell, destroying it in the process. The resultant immune response, combined with the chemicals and debris produced by theparasites, induces the fever, nausea, aches and other symptoms of a malaria infection.

How quickly should patient take medicine for malaria?

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QUESTION:

My sister has been suffering from malaria for three months. She consulted with doctor in the first symptom of malaria but doctor gave only fever medicine at that time. Blood test was not done at that time. So my question is: “within how many days or months malaria patient has to immediately take medicine?”

ANSWER:

One of our collaborating medical doctors has assisting in providing this answer:

It depends on the type of malaria….with Plasmodium vivax infection she could have a low burden due to concurrent treatment or recent prophylaxis which is breaking through because of low grade resistance. Alternatively, it could be P. malariae or P. ovale, both of which sometimes cause only mild disease that may or may not progress.  P. falciparum shouldn’t act this way; it is usually a much more severe, aggressive infection. Another option is that she might not have malaria at all.  She needs qualitative and quantitative smears to confirm the diagnosis, together with a comprehensive travel/exposure history to support any clinical suspicions.

 

 

Why are platelets low in malaria infections?

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QUESTION:

Why are platelets low in malaria infections? Why is there no internal bleeding in malaria?

ANSWER:

Platelets are low especially with P. falciparum infections, but also potentially with high-burden P. vivax infections. This is probably from sequestration in blood vessels and spleen. Actually, there is life threatening bleeding associated with severe cerebral malaria from this stasis and sequestration in the brain. Similarly, enlargement of the spleen leaves it susceptible to rupture, which would lead to critical internal bleeding.