Algorithms in the diagnosis and management of exotic diseases. XIII. Malaria.

Abstract

Malaria is a protozoal infection of man caused by four species of Plasmodium: falciparum, vivax, ovale, and malariae. These species are transmitted by female anopheline mosquitoes. Despite the wellpublicized efforts to eradicate malaria, it still remains endemic in the humid, warm areas of the world, including most countries of Central and South America, Africa, and Asia. All four species of Plasmodium commonly cause fever and chills, anemia, and splenomegaly. P. falciparum differs importantly from the others, however, in that it is capable of causing high-density parasitemia which can progress rapidly to massive hemolysis and fatal cerebral and renal complications. In the United States at the present time, most cases of malaria are found in travelers recently exposed to mosquitoes in endemic areas. In addition, transmission may occur by blood transfusion or by shared needles and syringes of drug addicts. The infection is rarely caused congenitally or by mosquito transmission from imported cases of malaria. The cardinal symptoms of acute malaria, chills and fever, are seen in so many common infections in the United States that American