Symptoms and diagnosis of malaria
Helminthiases / / August 12, 2017
During malaria distinguished periods: incubation (latent primary), primary acute manifestations, secondary latent, early relapse, interrecurrent and late relapses.
incubation period for falciparum malaria 9-15 days at 4-x day - 21-24 days, sometimes 5-6 weeks, with a three-day, caused by P. ovale and southern strain of P. Vivax - 10-21 days, with three daysthat makes the northern strain of P. vivax - 8-14 months.
The prodromal stage of malaria patients complain of malaise, weakness, aches in the whole body or the lower back, headaches.After 3-4 days of fever occurs.
fever in malaria have three phases - chill, heat and sweat.
During the first phase, patients complain of mild chilling, sometimes there is a stunning chills.Extremities cold, many patients with cyanosis of the ends of the fingers, the tip of the nose, lips, "goose bumps", severe headache, nausea and sometimes vomiting.The temperature was raised in 2-3 hours and reaches 39-40 ° C and higher digits.During the second phase of the
In the first three-day malaria attacks are repeated on a daily basis, the next - every other day.Malaria caused by P. ovale, clinical manifestations similar to the three-day (pathogen P. vivax), but it occurs in a milder form.At the four-day malaria attacks are usually repeated after 2 days, sometimes every day or 2 consecutive days with a one-day remission.
In mild falciparum malaria attacks occur every other day, sometimes every day.In critically ill they last 24-36 hours or more.Malaria attacks often occur in the same clock, but sometimes earlier or later than the previous one.
3-4 attack increased spleen and liver.When defective treatment and reinfection spleen reaches colossal proportions.As a result of the disintegration of red blood cells, hyperfunction of the reticuloendothelial system, reduce the bone marrow occurs hemolytic anemia, sometimes very heavy.The skin becomes pale yellow in color, sometimes with a dingy shade.There leukopenia with relative lymphocytosis and monocytosis.
If untreated, the number of attacks comes to 10-12 and more.After their termination in 12-15 days the spleen is reduced to normal size.After the initial attack of malaria should be a secondary latent period, followed by periods of relapse early.Recent clinical manifestations are not different from the primary paroxysms of malaria.For early relapses should interrecurrent period.It lasts for 8-10 months, sometimes more, and replaced later relapses.The last characteristic of vivax with a short incubation (southern strain of P. vivax temperate zone) and a four-day malaria.Clinical manifestations of distant recurrence lighter than the primary malaria attacks.Of course, described the cyclical flow of malaria observed in patients treated insufficiently.
In severe malaria are not uncommon lung disease in the form of focal and even hemorrhagic-necrotic pneumonia.Cardio-vascular system during the acute manifestations of malaria marked systolic murmur at the apex of the heart, a small increase in the size of the heart to the left, lowering blood pressure.In rare cases, heart failure occurs.Are common dyspeptic symptoms - nausea, vomiting, loss of appetite.Often there is a febrile albuminuria, nephritis sometimes with hypertension, albuminuria, edema.
protracted malaria manifests chronic hepatitis, anemia, severe or recurrent fever rudimentary.It is associated with inferior treatment, re-infection, duration of malarial infestation.There are so-called metamalyariynye diseases resulting from the transferred malaria.Such diseases include hypersplenism with anemia and leukopenia, chronic hepatitis, vegetative neurosis.Malaria parasites in patients lacking.
- Special malaria
diagnosis of malaria is based onclinical data - intermittent fever, skin palely yellow color with a puffy face, hepatosplenomegaly and other symptoms.Crucial in the detection of the patient's blood of malaria parasites.At the beginning of the disease the number of them is very meager, so you should watch a few thick drops.Blood test for malaria parasites is necessary in all febrile patients, particularly those coming from tropical countries.
Differential diagnosis is carried out with visceral leishmaniasis, tick spirochetosis, relapsing fever, rat bite fever, leptospirosis, brucellosis, pappataci fever, hemolytic disease due to cooling, blood diseases.