3 Malaria Clinical Features

7,321 views

Published on

Published in: Health & Medicine
2 Comments
9 Likes
Statistics
Notes
No Downloads
Views
Total views
7,321
On SlideShare
0
From Embeds
0
Number of Embeds
10
Actions
Shares
0
Downloads
190
Comments
2
Likes
9
Embeds 0
No embeds

No notes for slide

3 Malaria Clinical Features

  1. 1. CLINICAL FEATURES OF MALARIA febrile illness characterized by fever and related symptoms
  2. 2. Clinical Manifestations are related to cycle of events in relation to RBC
  3. 3. <ul><li>The first symptoms of malaria after the pre-patent period are called the  primary attack.  </li></ul><ul><li>Usually atypical (starts getting relapse of symptoms at regular intervals of 48-72 hours) </li></ul><ul><li>  short term relapses (recrudescences).   </li></ul><ul><li>  long term relapses  (after a gap of 20-60 days or more) </li></ul><ul><ul><li>due to the reactivation of the hypnozoites in the liver in case of vivax and ovale malaria. </li></ul></ul><ul><ul><li>In falciparum and malariae infections, recrudescences can occur due to persistent infection in the blood. </li></ul></ul>
  4. 4. Broad clinical manifestations of Malaria <ul><li>Fever </li></ul><ul><li>Sweating </li></ul><ul><li>Anemia </li></ul><ul><li>Splenomagaly (enlarged spleen) </li></ul><ul><li>Irratability </li></ul><ul><li>Coma, Retinal Hemorrages  </li></ul><ul><li>Algid Malaria ( a shocklike syndrome) </li></ul><ul><li>Respiratory distress syndrome </li></ul>
  5. 6. MANIFESTATIONS OF ACUTE MALARIA <ul><li>Fever and shivering . The attack begins with fever, with the temperature rising as high as 40ºC and falling again over a period of several hours. </li></ul><ul><li>A poor general condition , feeling unwell and having headaches like influenza. </li></ul><ul><li>Diarrhea, nausea and vomiting often occur as well. </li></ul>
  6. 7. MALARIAL PAROXYSM *typical features are seen after the infection gets established for about a week cold stage hot stage sweating stage <ul><li>feeling of intense cold </li></ul><ul><li>vigorous shivering </li></ul><ul><li>lasts 15-60 minutes </li></ul><ul><li>intense heat </li></ul><ul><li>dry burning skin </li></ul><ul><li>throbbing headache </li></ul><ul><li>lasts 2-6 hours </li></ul><ul><li>profuse sweating </li></ul><ul><li>declining temperature </li></ul><ul><li>exhausted and weak -> sleep </li></ul><ul><li>lasts 2-4 hours </li></ul>
  7. 8. PATTERN OF FEVER <ul><li>The fever paroxysm corresponds to the period of infected erythrocyte rupture and merozoite invasion. </li></ul>
  8. 9. ATYPICAL FEATURES <ul><li>Atypical fever </li></ul><ul><li>Headache </li></ul><ul><li>Body ache, back ache and joint pains </li></ul><ul><li>Dizziness, vertigo </li></ul><ul><li>Altered behaviour, acute psychosis </li></ul><ul><li>Altered sensorium </li></ul><ul><li>Convulsions, coma </li></ul><ul><li>Cough </li></ul><ul><li>Breathlessness </li></ul><ul><li>Chest pain </li></ul><ul><li>Acute abdomen </li></ul><ul><li>Weakness </li></ul><ul><li>Vomiting and diarrhoea </li></ul><ul><li>Jaundice </li></ul><ul><li>Pallor </li></ul><ul><li>Puffiness of lids </li></ul>
  9. 10. SEVERE MALARIA <ul><li>CEREBRAL MALARIA </li></ul><ul><li>SEVERE ANAEMIA </li></ul><ul><li>ACUTE RENAL FAILURE </li></ul><ul><li>PULMONARY OEDEMA OR ARDS </li></ul><ul><li>CIRCULATORY COLLAPSE OR SHOCK </li></ul><ul><li>SPONTANEOUS BLEEDING </li></ul><ul><li>GENERALIZED CONVULSIONS </li></ul><ul><li>METABOLIC ACIDOSIS </li></ul><ul><li>HYPOGLCEMIA </li></ul><ul><li>BLACK WATER FEVER </li></ul>
  10. 11. Cerebral Malaria <ul><li>Coma </li></ul><ul><li>diffuse symmetric encephalopathy </li></ul><ul><li>Unusual focal neurological signs </li></ul><ul><li>Primitive reflexes absent </li></ul><ul><li>Retinal haemorrhage with puillary dilatations </li></ul><ul><li>Hemiplegia, CP </li></ul><ul><li>Blindness, deafness </li></ul><ul><li>Impaired cognition and learning </li></ul>
  11. 12. Anemia
  12. 13. Acute renal failure
  13. 14. Metabolic acidosis
  14. 15. Hypotension
  15. 16. Pulmonary edema
  16. 17. Hypoglycemia <ul><li>MULTIFACTORIAL </li></ul><ul><li>Parasite utilises the glucose </li></ul><ul><li>Associated with hyperlactatemia </li></ul><ul><li>Due to hepatic failure gluconeogenesis and glcogenolyis are affected </li></ul><ul><li>Quinine – pancreatic beta cell stimulation </li></ul>
  17. 19. Black water fever <ul><li>due to intravascular hemolysis at schizogony period </li></ul><ul><li>Predisposing factors </li></ul><ul><ul><li>quinine </li></ul></ul><ul><ul><li>cold exposure </li></ul></ul><ul><ul><li>fatigue </li></ul></ul><ul><ul><li>trauma </li></ul></ul><ul><ul><li>pregnancy </li></ul></ul><ul><ul><li>parturition </li></ul></ul>
  18. 20. <ul><li>Effects </li></ul><ul><ul><li>Methaemoglobuminaemia </li></ul></ul><ul><ul><li>Hyperbilirubinaemia </li></ul></ul><ul><ul><li>Haemoglobinuria </li></ul></ul><ul><li>Pigments </li></ul><ul><ul><li>Oxyhaemoglobin </li></ul></ul><ul><ul><li>Methaemoglobin </li></ul></ul><ul><ul><li>Bilirubin </li></ul></ul><ul><ul><li>Methaemalbumin </li></ul></ul>
  19. 21. <ul><li>Symptoms </li></ul><ul><ul><li>rapid pulse </li></ul></ul><ul><ul><li>high fever and chills </li></ul></ul><ul><ul><li>extreme prostration </li></ul></ul><ul><ul><li>a rapidly developing anemia </li></ul></ul><ul><ul><li>the passage of urine that is </li></ul></ul><ul><ul><li>black or dark red in colour </li></ul></ul><ul><ul><li>Fever, rigor, aching pain in loin, </li></ul></ul><ul><ul><li>icterus, vomitting, circulatory collapse, acute renal failure </li></ul></ul>
  20. 22. MALARIA IN PREGNANCY <ul><li>Foetal </li></ul><ul><ul><li>IUGR  LBW </li></ul></ul><ul><ul><li>Still birth </li></ul></ul><ul><ul><li>Prematurity  increased risk of neonatal death </li></ul></ul><ul><ul><li>Fetal distress </li></ul></ul><ul><li>Maternal </li></ul><ul><ul><li>Anaemia  risk of maternal mortality </li></ul></ul><ul><li>Mortality due to cerebral malaria is higher </li></ul>
  21. 23. MALARIA IN CHILDREN <ul><li>Convulsions </li></ul><ul><li>Coma </li></ul><ul><li>Hypoglycemia </li></ul><ul><li>Metabolic acidosis </li></ul><ul><li>Severe anemia </li></ul><ul><li>Deep jaundice </li></ul><ul><li>Acute renal failure </li></ul><ul><li>Acute pulmonary edema </li></ul>

×