Can malaria cause kidney failure?

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QUESTION:

Can malaria be a cause for kidney failure or brain fever?

ANSWER:

Malaria, and specifically Plasmodium falciparum malaria, the most severe and deadly form of the disease, can certainly cause both renal failure and brain fever. It usually does this by infecting red blood cells, which then become blocked in tiny blood vessels deep within organs. This process is called sequestration. When sequestration happens in the brain, the effect can be so-called “cerebral malaria” or brain fever. In the kidney, this can result in kidney failure. Given these severe consequences, it is crucially important to seek diagnosis and then treatment immediately if you are concerned you might be suffering from malaria.

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.

Malaria and Jaundice

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QUESTION:

Why are patients suffering with malaria more susceptible to jaundice?

ANSWER:

The icterus/jaundice is usually from lysis/breakdown of infected red blood cells as they rupture and release new malaria parasites into the bloodstream.  If only 1% of red cells are infected, this will be mild.  If “parasitaemia” is severe/life threatening, say, 10% of red cells infected, then the jaundice will be dramatic as well as a risk for catastrophic organ failure from cell breakdown, iron deposition into capillaries/small blood vessels in brain/kidneys/liver. In such cases, exchange blood transfusion could be life-saving.


Can malaria affect the liver and stomach?

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QUESTION:

Can malaria affect the liver and stomach? I had two attacks of P. falciparum few years back. Now I doubt there is some swelling under my right rib bone. Please clear my doubt.

ANSWER:

Malaria can certainly affect many of the organs in the body, including the stomach and liver. This is due to the sequestration (attachment) of red blood cells to the tiny blood vessels in these organs, and is especially common in infections with P. falciparum. Given the large amount of blood that flows through the liver, this is a common organ to be affected by malaria, and can often seen to be swollen during the infection. However, it is unusual for the enlargement to persist after treatment, and so I would recommend you visit your doctor or hospital to check out any residual concerns you might have.

Malaria and Loss of Red Blood Cells

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QUESTION:

What is the percentage of red blood cell that is lost at the onset of malaria symptoms?

ANSWER:

This depends entirely on the severity of the malaria infection, and also the type of malaria. Malaria parasites, called Plasmodium, invade red blood cells and use them for rapid, asexual reproduction. After a certain number of multiplications, the parasites burst out from the red blood cell, destroying it. This process leads to the reduction in red blood cells, and causes anaemia in the patient. The most deadly type of malaria, Plasmodium falciparum, takes just 24 hours to complete its cycles of reproduction. Therefore it can very rapidly produce many more parasites, which spread quickly through the blood, reducing the number of red blood cells very quickly.

White Blood Cells and Malaria

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QUESTION

Does malaria cause loss of white blood cells / antibodies?

ANSWER

The parasites that cause malaria reproduce in the human host by infecting red blood cells, then multiplying asexually and bursting out into the bloodstream, ready to infect more red blood cells.

As such, malaria parasites do not destroy white blood cells. However, patients with malaria may display reduced white blood cell counts during blood tests; this is usually thought to be due to relocalization of the white blood cells from the limbs (where blood is usually taken from during these tests) to the spleen and other internal organs also affected by the malaria infection.

As for antibodies, the malaria parasites contain antigens, which are proteins that cause an antibody response in the patient, thus usually resulting in an increase in antibodies during infection, especially if the patient has been exposed to malaria previously.

Having Malaria after being tested negative

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QUESTION:

In April 2010 I was in India, had symptoms of malaria, had blood work done, platelets low but rapid antigen and smear were negative. One year later, May 2011, had low platelet count, chills, no fever or fever spikes. Could this be malaria again even though I was tested negative.

ANSWER:

This response is courtesy of Dr Jaya Swarup Mohanty, a physician in India:

Malaria doesn’t affect the platelet count or the white blood cell count. The Plasmodium species causing malaria are either lodged in the hepatocytes (liver cells) or the RBCs (red blood cells) where they undergo asexual multiplication.
Any change in platelet count would rather indicate dengue (another mosquito borne disease with fever, chills, prostration, bone pain, low platelet count) or some blood disorders (where there would only be decrease or increase in platelet count). In this case there is only low platelet count and chills with no fever or fever spikes which may indicate some disorder in blood or immune system or as a reaction to some medication. It would be advisable to consult a physician as soon as possible for further work up.

Causes of Malaria

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QUESTION:

What causes 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 characterise malaria infection episodes.