Malaria and its skin signs

Authors: Ellie Dodson, Medical Student, University of Bristol, United Kingdom; Dr Lauren Thomas, RMO, Royal Darwin Hospital, Darwin, NT, Australia; Niket Shah, Medical Student, University of Otago, Wellington, New Zealand. Copy edited by Gus Mitchell. November 2020.

What is malaria?

Malaria is a blood-borne tropical infection caused by parasitic protozoa of the genus Plasmodium transmitted between people via infected female Anopheles mosquitoes.

Who gets malaria?

Malaria only occurs in the 91 tropical and subtropical countries where the Anopheles mosquitoes can survive, multiply, and complete their growth cycle. Disease incidence within these countries further depends on environmental factors including altitude, climate, and vegetation. In 2016, the World Health Organisation (WHO) estimated 90% of malaria cases in the world occurred in sub-Saharan Africa, but other regions at risk included South-East Asia, Central and South America, and parts of the Middle East. The WHO World Malaria Report for 2019 estimated 229 million cases and 409,000 deaths in that year.

Children under 5, pregnant women, and the immunosuppressed are at the highest risk of contracting malaria.

As malaria is a blood-borne disease, it is possible to contract it from blood transfusions and the sharing of needles, but this is rare.

What causes malaria?

Malaria is caused by just four of the many species of Plasmodium protozoa. These are:

• P. falciparum
• P. vivax
• P. malariae
• P. ovale.

The Plasmodium protozoa are spread by the female Anopheles mosquito which bites between dusk and dawn. The mosquito deposits the protozoa in the intervascular skin matrix, from where the microorganisms invade the bloodstream and rapidly establish infection in the liver. The parasites mature and multiply in the liver over several days before entering red blood cells for their final growth phase. The infected red cells burst open to release protozoa into the bloodstream where another mosquito can incidentally collect them during a blood-feed. This phase of parasitaemia, when many parasites are circulating in the blood, corresponds to an acute attack of symptoms.

What are the clinical features of malaria?

Symptoms of malaria usually develop 10–15 days after an infectious mosquito bite (range 7 days to 3 months). An acute attack of uncomplicated malaria lasts 6–10 hours and presents with fever, chills, headache, cough, myalgia, abdominal pain, vomiting, and diarrhoea. Progression to severe malaria involves organs including the brain, kidney, or lungs, or blood disturbances such as severe anaemia, metabolic acidosis, hypoglycaemia, or disseminated intravascular coagulation (DIC).

What are the cutaneous features of malaria?

Apart from the visible mosquito bites, cutaneous findings are rare and non-specific in malaria, but have been reported with P. falciparum and P. vivax malaria. Reported cutaneous findings include:

• Urticaria
• Angioedema
• Petechiae
• Purpura
• Reticulate erythema over the limbs sparing palms and soles.

Mucosal involvement has not been reported.

Skin signs may indicate complications such as jaundice, anaemia, and DIC.

Skin side effects of malaria treatment and chemoprophylaxis

Tetracyclines can cause photosensitivity including photo-onycholysis. Photosensitivity is an important adverse effect in tropical countries, and appropriate sun protection should be recommended when doxycycline is prescribed for chemoprophylaxis in travellers.

Hydroxychloroquine can cause morbilliform or psoriasiform rashes in up to 10% of people.

What are the complications of malaria?

Uncomplicated malaria can progress to severe disease, with organ involvement including:

• Pulmonary oedema and acute respiratory distress
• Acute renal failure
• Cerebral malaria, epilepsy, reversible post-malaria neurological syndrome, and permanent visual, motor, or language disorders
• Hyper-reactive malarial splenomegaly (very enlarged spleen) and splenic rupture.

P. falciparum malaria in pregnancy can cause severe disease in the mother resulting in premature delivery or low birth-weight baby. Congenital malaria is due to transplacental infection from the mother or during delivery and presents in the first 48 hours after birth. Neonatal malaria presents three weeks after birth following an infected mosquito bite. Both forms carry a high mortality rate.

Relapses can occur months or years after P. vivax or P. ovale infection following reactivation of dormant liver parasites.

How is malaria diagnosed?

Malaria should be considered in anyone with a febrile illness in an endemic area, or after visiting an endemic area in the previous 12 months.

Malaria is diagnosed on microscopic examination of a blood film. Thick blood film examination provides sensitivity. Thin blood film examination allows speciation and quantitation. If the initial film is negative, blood should be reassessed every 6–12 hours for 36–48 hours before malaria can be confidently excluded.

Antigen-based rapid diagnostic tests (RDT) detect specific antigens produced by the parasite. Some are species specific, while others can detect multiple species.

What is the differential diagnosis for malaria?

Malaria presents as a nonspecific acute febrile illness. The differential diagnosis therefore is long and includes many other tropical infectious febrile illnesses, including:

• Dengue fever
• Typhoid fever
• Brucellosis
• Leishmaniasis
• African/American trypanosomiasis
• Rickettsial diseases.

What is the treatment for malaria?

The best treatment option for malaria is prophylaxis including clothing, netting over beds, mosquito repellents, and chemoprophylaxis with medications such as doxycycline and hydroxychloroquine, depending on the geographic location. Work on vaccine development continues.

Vector control to prevent the spread of mosquitoes can include:

• The destruction of areas of stagnant water where mosquitoes breed
• Treatment of houses and netting with insecticide
• Release of sterile male mosquitoes
• Genetic modification of mosquitoes to reduce disease susceptibility.

General measures

Treatment may be required for:

• Secondary infection
• Electrolyte and fluid imbalance
• Anaemia
• Hypoglycaemia.

Antihistamines have been reported to ease the symptoms of cutaneous involvement.

Supportive measures for complications may also include ventilation and/or dialysis.

Specific measures

The medication used for prophylaxis and treatment will depend on drug resistance and severity of disease. Drugs used include:

• Doxycycline
• Clindamycin
• Hydroxychloroquine and chloroquine
• Artemisinin derivatives, such as artesunate and artemether.

What is the outcome for malaria?

Full recovery from malaria is expected with appropriate prompt treatment. However, treatment is not always curative due to drug resistance, high parasite density, treatment noncompliance, low host immunity, and poor drug bioavailability. Recurrent symptoms with detectable parasitaemia can occur 2–6 weeks after apparently successful treatment.

Urticaria is reported to subside 12–48 hours after starting antimalarial treatment. All skin symptoms resolve within days of treatment without recurrence.

Cerebral malaria and anaemia in children can result in persistent movement disorders, speech difficulties, deafness, blindness, behavioural issues, and epilepsy.

Severe malaria can deteriorate rapidly, with death within hours or days due to missed or delayed diagnosis, but also sometimes despite appropriate treatment and intensive care.

P. falciparum malaria can be rapidly fatal within 24–48 hours of presentation, especially in children.

In 2018, there were an estimated 228 million cases of malaria, and 405,000 deaths (mostly children) worldwide.

Malar rash: Causes, symptoms, and treatment

A malar rash is a skin rash that appears on the cheeks and bridge of the nose. It occurs due to certain conditions, such as lupus. It is also known as a “butterfly rash” due to its distinctive butterfly shape.

A malar rash may be flat or slightly raised, and it can feel rough and scaly. The rash is often red or purple and may be either blotchy or solid in appearance. It may be itchy and, in severe cases, it may be painful.

Many health conditions can cause a malar or butterfly rash, including:

• lupus
• genetic disorders
• bacterial infections
• rosacea
• sun exposure

In this article, we examine the possible conditions that could be behind a malar rash, along with other symptoms that may occur. We also look at diagnosis and treatment options.

Share on PinterestA malar rash occurs on the cheeks and bridge of the nose.

Causes of the malar rash include:

• autoimmune diseases, such as lupus
• bacterial infections, such as Lyme disease
• inflammatory skin disorders, such as rosacea
• vitamin deficiencies, such as pellagra
• genetic disorders, such as Bloom syndrome
• sensitivity to ultraviolet rays in sunlight

Lupus or SLE

Lupus is a chronic autoimmune condition where a person’s immune system attacks healthy tissue. It is also known as systemic lupus erythematosus or SLE.

Lupus results in inflammation of joints, skin, and other organs. While there is no cure, treatment can improve some of the symptoms.

Around half of all people diagnosed with lupus will develop a malar rash as a symptom. One study recorded a prevalence of 61 percent.

Rosacea

This common skin condition affects 16 million Americans and 415 million people worldwide. It is characterized by:

• redness of the skin
• flushing
• hard or pus-filled pimples

Seborrheic dermatitis

Seborrheic dermatitis is a common inflammatory disease of the skin characterized by greasy or dry scales usually on the scalp, hairline, and face, although it can affect many other areas of the body.

When someone has dandruff, they have a mild form of seborrheic dermatitis.

Cellulitis

Cellulitis is a type of bacterial infection that affects the deeper skin layers plus the layer of fat that is stored directly under the skin.

Lyme disease

This is caused by a tick bite, which then transmits bacteria into the body. Other symptoms may include:

• joint pain
• stiffness
• severe headaches
• dizziness

Dermatomyositis

This is a condition involving inflammation of the muscles, connective tissues, and skin. Unlike SLE, the associated rash impacts the folds of skin that run from either side of the nose to the corners of the mouth.

Pellagra

When someone eats a diet that is extremely low in niacin, one of the B vitamins, it can lead to Pellagra.

This condition causes a range of symptoms that affect the skin, central nervous system, gastrointestinal system, and mucous membranes, such as the lining of the mouth. These symptoms can include pain and swelling.

Bloom syndrome

Bloom syndrome, which is also called Bloom-Torre-Machacek syndrome, is an inherited disorder that is characterized by short stature and elevated rates of most cancers.

Among other symptoms, it causes a malar rash and skin eruptions on other areas of the body.

Homocystinuria

Homocystinuria is a genetic disorder where the body is unable to process the amino acid methionine, leading to harmful levels of this and the chemical homocysteine in the blood and urine.

The condition can also result in vision problems, skeletal abnormalities, and intellectual disability.

Erysipelas

Erysipelas is a skin infection caused by Streptococcus bacteria. It results in acute skin inflammation. This is a rare cause, but it may also affect the ears and the face.

Photosensitivity

Sunburn or sensitivity to sunlight may cause a malar rash, and it may worsen one if it already exists.

Share on PinterestDue to the wide range of possible causes, a doctor will need to perform a physical examination during diagnosis.

Diagnosing the condition behind a malar rash can be difficult because of the wide range of possible causes.

A doctor will take a full and detailed medical history and investigate all other symptoms, as well as perform a thorough physical examination.

Infectious causes may be determined through a tissue biopsy or microbiological tests, while pellagra may be diagnosed through testing of niacin levels. Genetic studies may be carried out to confirm genetic disorders.

If the doctor suspects SLE, they will use blood and urine tests, such as:

• SR (erythrocyte sedimentation rate) test to look for inflammation in the body
• C-reaction protein test, as high CRP levels are another sign of inflammation
• X-rays to check for organ damage
• anti-nuclear antibody test

Treatment of a malar or butterfly rash depends on its cause.

Lupus

In the case of lupus, treatment involves:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Anti-inflammatory medications to reduce the inflammation and pain in muscles, joints, and other tissues.
• Anti-malarial drugs: These may help with joint and skin conditions, as well as fatigue.
• Steroids: Steroids work quickly to relieve pain, stiffness, and swelling. They have some unpleasant side effects, and the dosage is usually reduced once the disease is under control. Doctors can also prescribe steroidal creams.
• Immunosuppressive medications: These drugs are now also used for the treatment of some autoimmune diseases, including lupus, as they help to suppress the immune system.

Rosacea

Treatment for rosacea may include creams or gels to help soothe and repair the skin and reduce redness, as well as oral antibiotics to control inflammation.

Bacterial infection

Causes linked to bacterial infection are treated with oral or topical antibiotics.

Share on PinterestProtecting a person’s face from the sun may help the skin to heal, and prevent the rash from worsening.

Protecting the face from sun helps reduce malar rash. There are several ways people can help their skin to heal and prevent the rash from worsening, including:

• protecting the face from the sun
• using skin products for sensitive skin
• eating a healthful, balanced diet

People are advised to avoid foods that increase inflammation, including:

• red meat
• dairy
• fried food
• refined and processed foods
• saturated fats and hydrogenated fats
• foods high in sugar

Malar rashes are relatively common, though rarely present a problem themselves.

Rashes caused by bacterial infections can be successfully treated and cured.

Chronic diseases or genetic conditions, such as SLE and Bloom syndrome, cannot be cured, but their rash symptoms may improve with treatment.

Malaria: symptoms, pathogens, treatment, doctor’s advice

The article was commented and checked by Anna Tsygankova, senior medical consultant at the medical company BestDoctor

• What is malaria
• Exciters
• Varieties
• Symptoms
• Diagnostics
• Treatment
• Inoculation
• Prophylaxis
• Malaria in Russia
• Expert commentary

What is malaria

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Malaria is one of the most common infectious diseases in the world. It is caused by plasmodia parasites carried by malarial mosquitoes. The incubation period of the disease can last from 11 days to several months. The main symptom is regular bouts of severe fever that occur every two to three days. In severe forms, the disease can lead to dangerous organ damage.

Even 80 years ago, malaria was spread all over the globe. However, thanks to the development of the economy and medicine, today the disease has been defeated in half the countries of the world and is rampant only in hot developing countries. Scientists believe that humanity will be able to completely defeat malaria by 2050, although this will require spending an additional $2 billion a year to fight it [1].

According to WHO, about 228 million people fall ill with malaria each year, of which 400,000 die. 94% of malaria cases are reported in Africa, half of them in six countries: Nigeria, Congo, Tanzania, Burkina Faso, Mozambique and Niger. Children from six months to five years of age, who are completely immune to the disease, suffer the most from malaria. They account for two thirds of malaria deaths.

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Tourists and travelers are often infected with malaria. According to WHO, about 10,000 people annually bring the disease from foreign trips.

Malaria

The disease is carried by mosquitoes of the genus Anopheles, infected with malarial plasmodia, protozoan parasites, which are the direct causative agents of the disease. Malarial mosquitoes live mainly in swamps and in small stagnant water bodies, including puddles. Many countries have eradicated malaria through massive swamp draining campaigns.

Two hundred species of malarial mosquitoes can be found all over the planet, except for deserts and territories of the Far North. In Russia, the species Anopheles Messeae is common. However, he stopped carrying the disease over 50 years ago. Today, malaria can only be contracted from Asian and African species of malarial mosquitoes.

First, the malarial mosquito drinks the blood of a person infected with malaria. Plasmodium enters his intestines. It then bites another person and transfers the parasite larvae to them. Those first enter the liver, where they grow and develop. When Plasmodium become adults, they pass from the liver into the bloodstream, after which the first symptoms of malaria appear in humans. Some varieties of Plasmodium can doze in the liver for a long time.

Malaria can also be transmitted from person to person without the involvement of mosquitoes: from mother to child (very rare), through blood transfusion and by sharing injection needles.

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Types of malaria

Of the several hundred malarial plasmodia, only five are dangerous to humans. Each one causes a different kind of disease.

Three-day malaria

Plasmodium vivax causes three-day malaria (vivax-malaria) – a relatively mild form with a long course. It is characterized by the fact that malarial attacks of fever occur every two days, often at the same time of the day, from 11 am to 4 pm. Another variety of the pathogen, P. ovale, causes ovale malaria, which is similar to three-day malaria.

P. Vivax is distributed in Tajikistan, Afghanistan, Pakistan and Nepal, as well as in Central America and northern South America. Previously, this particular type of plasmoid was common in Europe and Russia. P. ovale is found mainly in Africa, where the Plasmodium that causes dengue is found.

Four-day malaria

P. malariae causes four-day malaria, in which attacks occur every 70-72 hours. This form is not as severe, but in rare cases it can cause serious damage to the kidneys – nephrological syndrome. Plasmodium of this type can live hidden in the human body for decades even after recovery. They cause a fairly rare type of malaria found in India, Indonesia, Cambodia and Laos.

Tropical malaria

P. falciparum causes tropical malaria. This is the most dangerous type of the disease, and at the same time the most common – it accounts for more than 90% of infections. Attacks occur irregularly, and the disease affects the vessels, which can lead first to hypoxia, and then to organ failure. This type of illness dominates all of Africa, and in countries such as India, Vietnam, and Thailand, it occurs about as often as three-day malaria.

Malaria Knowlesi

The possibility of human infection with P. knowlesi was discovered only in 2004 – it was previously thought that it only infects macaques. This type of malaria develops the fastest and is therefore very dangerous if treatment is delayed [2]. The features of the course of this type of malaria are still poorly understood, but researchers call this form no less severe than tropical [3]. This type of malaria is common in Southeast Asia, primarily in Malaysia, the Philippines and Indonesia.

Symptoms of malaria

Most often, the first symptoms of malaria appear 11-30 days after infection, although both types of Plasmodium, which cause the three-day form, can sleep in the liver for up to 15 months.

At the first stage of the disease, pathogens multiply and accumulate in the blood, and the symptoms resemble general poisoning – a person is shivering, nauseous, he experiences weakness, body aches and pain in the joints and limbs. Distinguishing malaria from other infectious diseases at this stage is very difficult.

When there are many Plasmodium in the blood, the peak of the disease sets in, which consists of recurring malarial attacks, or paroxysms. Depending on the type of disease, attacks occur every other day or every two to three days.

An attack lasts from 15 minutes to two hours. Symptoms resemble the flu: the temperature rises sharply to 39-41 °, the pressure drops, breathing quickens. A person is sick or vomits, he may become delirious. Then the temperature drops sharply, the patient feels severe weakness and quickly falls asleep. Rashes similar to herpes may appear on the lips. Waking up, a person feels healthy, but after a while the attack is repeated. When the patient begins to recover, the attacks become less severe and eventually disappear altogether.

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In all patients with malaria, by the fifth or seventh day of illness, the liver and spleen become enlarged, and in addition, anemia (anemia) develops.

According to the clinical picture, malaria is divided into uncomplicated and severe, in which the disease causes not only attacks, but also damage to organs.

The main complications of malaria are:

Nephrotic syndrome

This is a dangerous, almost untreatable kidney disease that can occur with four days of malaria.

Cerebral malaria

Brain damage, which most often develops due to inadequate treatment. It begins with headache and mild impairment of consciousness, and if left untreated can lead to coma and death.

Algid form of malaria

Toxic shock, which occurs due to the huge content of parasites in the blood. It begins with symptoms of severe intoxication, can lead to coma and death.

Hemoglobinuric (blackwater) fever

An extremely serious complication of dengue fever, which most often occurs when treatment is started late. After taking drugs, there are too many dead plasmodia and dead red blood cells in the human blood at the same time, which die due to drugs. The most characteristic manifestations are vomiting of black bile and black urine. Some studies have associated this complication with quinine, a drug used to treat severe forms of malaria.

Tears and organ failure

Malaria can severely damage the kidneys, liver or spleen, the latter up to rupture.

Malaria diagnosis

The vast majority of Europeans are diagnosed with malaria after visiting tropical countries where the disease is present.

In its early stages, malaria develops in the same way as many other infectious diseases. The main method of accurate diagnosis is blood smear microscopy, which allows detecting parasites. Only after their identification, the doctor can make a final diagnosis.

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Less accurate methods of immunological diagnostics are used, in which specific antibodies or antigens of Plasmodium are searched in the blood.

There are also rapid tests for parasite antigens, but they are not very accurate.

Treatment of malaria

In Russia and other non-endemic countries for malaria, it is treated only in a hospital.

To cure the disease, it is necessary to kill the plasmodia in the blood. For this, antiparasitic drugs are used.

The most common treatment for uncomplicated malaria today is combination therapy. Most often, it contains artemisinin or its derivatives – this is an antiparasitic drug that is made from wormwood (artemisia). It is effective against all types of malarial plasmodia, but treatment with it alone often leads to relapse. Therefore, artemisinin is supplemented with other, more specific antimalarial drugs. In addition, if mass treatment of malaria with only artemisinin, Plasmodium will inevitably develop resistance to it over time, and humanity will be almost defenseless against the disease. In Russia, drugs based on artemisinin are not registered. Malaria ovale is treated with a combination of primaquine and chloroquine.

Main drugs used in the treatment of malaria:

• chloroquine;
• hydroxychloroquine;
• primaquine;
• quinine;
• mefloquine;
• artemisinin;
• artesunate;
• artemether;
• arteeter;
• proguanil;
• tetracycline;
• doxycycline.

The choice of remedy depends on the form of malaria and also on the region in which the infection occurred [4]. For example, the malarial plasmodia of Afghanistan and Pakistan have developed resistance to chloroquine, while the Thai and Myanmar parasites have also developed resistance to mefloquine [5].

In the treatment of malaria with complications, antimalarial drugs are supplemented with specific drugs for the affected organs.

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Malaria vaccine and malaria immunity

The only working malaria vaccine, RTS,S, was created in the late 1980s, but only received EU approval in 2015. It has a rather low efficiency – RTS,S provides 27% protection against all forms of malaria and 58% from severe ones [6]. Today, it is being vaccinated in children in countries where malaria is most common, and is not available to travelers and residents of developed countries.

People living in countries where malaria is present may have an innate immunity to it. West African and African American populations have the Duffy gene, which makes them immune to infection with three-day malaria. Other genetic factors may make them more resistant to tropical malaria as well. Also, the risk of getting malaria is lower in people suffering from sickle cell anemia, a rare genetic disease that also occurs mainly in blacks [7].

After an illness, a person develops unstable acquired immunity, which grows stronger with each re-infection. In an immunocompetent patient, malaria can be almost insidious, with very low levels of parasites in the blood. In societies where people are constantly exposed to malaria and are infected with it several times a year, many develop strong immunity to the disease by the age of puberty [8].

Malaria prevention

Prevention of malaria is mainly about protection from mosquito bites. WHO recommends wearing full-body clothing and using insect repellents on the skin and living quarters. Of the repellents, it is best to use products that contain DEET, IR3535 or icaridin. International organizations distribute mosquito nets impregnated with mosquito repellents in countries with malaria – they are considered one of the most convenient, simple and effective ways to protect against the disease [9].

There is also a group of antimalarial drugs that are effective in preventing the disease. Doctors advise taking antimalarial drugs before traveling to a malarial country, as well as during travel and for some time after it. In Russia, mefloquine and chloroquine are most often prescribed. Only a doctor can choose the right drug.

Rospotrebnadzor recommends that tourists returning from countries with malaria monitor their temperature for three years after their trip.

Malaria in Russia

From prehistoric times to the middle of the 20th century, malaria was common throughout the world (except for the Far North), including most of Russia.

In Rus’, the disease was called “shaking”, “pale” or “death”. In the mid-1930s, a large-scale malaria epidemic swept through the Soviet Union, which affected the Volga region, the Urals and Ukraine. However, industrialization, the drainage of swamps and the development of medicine gradually helped to cope with malaria. At 19In 1962, the authorities announced that the disease was completely defeated.

After the collapse of the Soviet Union, the disease returned to Central Asia. In the 2000s, the majority of infections imported into Russia were associated with migrants from Tajikistan, Azerbaijan and Uzbekistan. However, the situation there quickly improved – today the only post-Soviet state where endemic malaria is present is Tajikistan, but it is also close to completely defeating the disease [10].

For the last decade, 80-120 cases of malaria have been registered in Russia per year. All of them are imported, most often from Africa, as well as from India, Thailand, Latin America and the countries of the Middle East [11].

In 2020, Tanzania became the main supplier of malaria to Russia, one of the few countries that did not close the borders for tourists. According to the head of Rospotrebnadzor Anna Popova, 11 cases of malaria were imported from there. Two patients are known to have died.

Expert comments

Anna Tsygankova, Senior Consultant, BestDoctor Medical Company

How toxic are malaria drugs? What side effects can they have?

Any drug may cause side effects. In the case of malaria chemoprophylaxis, drugs are used that are supposed to kill the parasite, and they are quite toxic. However, there is a concept of risk-benefit, that is, chemoprophylaxis for a European is potentially much less harmful than malaria. All registered prophylactic drugs have undergone post-marketing studies and have proven their effectiveness and safety. Mild nausea, occasional vomiting, and frequent loose stools should not lead to discontinuation of prophylaxis, but if these symptoms persist, medical advice should be sought. A rare complication (1 in 10,000 travelers) has been described when taking mefloquine: the development of neurological symptoms, seizures, and psychosis.

Can the complications of malaria lead to fatal organ dysfunction, disability or disability?

If you seek medical help and start treatment in time, then malaria disappears completely. Severe forms of the disease are individual, in some cases they lead to death. Four-day malaria has a specific complication. It may not cause acute symptoms, but low levels of parasitemia (the presence of Plasmodium in the blood) may persist for many decades and lead to immune complex-mediated nephritis with the development of nephrotic syndrome. This is a serious condition that can make a person disabled: protein is lost through the kidneys, pronounced edema is formed, lipid metabolism is disturbed, and the risk of developing infectious diseases increases. This condition occurs in children in endemic areas in Africa.

Clinical manifestations, treatment and diagnosis of malaria disease – clinic “Dobrobut”

Malaria on the lips of a person – clinic and treatment

Malaria is an infectious disease, a characteristic feature of which is a paroxysmal relapsing course. The fight against the symptoms of malaria should begin at the first manifestations. Otherwise, severe complications are not excluded, which include pulmonary edema, acute renal failure, severe anemia, malarial coma. The disease is widespread in southeast Asia, Africa and Oceania.

Ways of infection: transmissible, parenteral and transplacental. The causative agent of malaria is a protozoan parasite called Plasmodium. This is a seasonal disease of the autumn-summer period.

Malaria forms:

• three-day;
• four-day;
• oval malaria;
• tropical infectious.

Each has its own characteristics and requires an individual approach to treatment.

Forms and development of signs of malaria

Three days. The incubation period is from two to eight months. The main manifestations are intermittent fever, enlargement of the liver and spleen, and anemia. In general, the prognosis is favorable. However, without proper treatment, malaria threatens with complications such as nephritis and malarial hepatitis.

Four-day malaria. The incubation period is three to five weeks. To the above symptoms, you can add a daily slight increase in temperature. The treatment of this form of the disease is largely identical to the treatment of three-day malaria. About how to treat three-day malaria, read on.

The tropical infectious form is usually severe. Without timely medical treatment, death can occur. The incubation period is up to 7 days. The disease is characterized by longer bouts of fever. Against the background of severe intoxication, the patient may experience convulsions, headache, insomnia, confusion. Perhaps the development of renal pathology and toxic hepatitis.

Malaria ovale. Symptoms are similar to the three-day form. The incubation period is 7-11 days. The main drug for the treatment of malaria are drugs based on quinine.

Periods of disease development:

• incubation;
• primary acute;
• secondary;
• relapse.

The sequence of occurrence of malaria in children

The disease in children is severe and specific. Characterized by atypical fever without chills and sweating. At the beginning of the disease, the temperature reaches its maximum, after which it stabilizes at subfebrile levels for several days. Against the background of intoxication, the child may develop convulsions, vomiting, cyanosis, diarrhea. In some cases, a hemorrhagic rash appears. Without timely treatment, there is a high probability of developing persistent anemia and hepatosplenomegaly. In more detail about the sequence of occurrence of malaria in childhood, the doctor will tell you at a personal appointment. You can sign up for a consultation on our website Dobrobut.com or by phone. The doctor will answer questions and tell you why there is still no vaccination against malaria in children.

Clinic of the disease

The incubation period, as a rule, does not manifest itself in any way. As signs of malaria develop, the patient may complain of increased sweating, increased heart rate, increased blood pressure, and a sharp change in feeling hot with chills. The tropical infectious form of the disease is characterized by partial cyanosis of the extremities and heavy breathing.

After the attack is over, the patient’s temperature may rise to 39-40 degrees. The skin becomes dry and red. In some cases, convulsions are possible, there is a violation of the mental state. It should be noted that each attack of the disease is accompanied by profuse sweating.

Lip malaria in humans

The disease can manifest itself on the lips for various reasons:

• weakened immunity;
• general exhaustion of the body;
• food poisoning;
• constant stress.

Clinical manifestations of malaria on the lips in humans: redness and itching in the area of ​​the nasolabial triangle, small blisters in the corners of the lips.

Diagnostic measures

Diagnosis of malaria disease includes a blood test, urinalysis, additionally serological methods – RIF, RFA, RNGA.

Microscopic examination of blood helps to determine the type, type and quantity of microbes. For this purpose, two types of smear are used – thin and thick.

In the general analysis of urine in a patient, hemoglobinuria and hematuria.

Treatment of malaria

Drug therapy is most effective in a hospital setting. The patient is prescribed hingamin, quinine, chloridine or chloroquine. In some cases, the use of sulfonamides and antibiotics is justified. As an additional treatment, detoxification therapy (rheopolyglucin, gemodez, saline), drugs that restore microcirculation, and decongestants are recommended. In severe cases, hormones, plasma and red blood cell transfusions are used.

Prevention of the disease

The main preventive measures are the identification of carriers of malarial plasmodium and already sick people, conducting epidemiological surveillance, extermination of mosquitoes and prophylactic administration of special preparations before traveling to a risk zone. In the latter case, we are talking about the specific prevention of malaria. It is recommended to take pills 2 weeks before departure and within 2 weeks after it.