Topic: Malaria

Etiology: Species affect the man: a) Plsmodium falciparum b) Plasmodium vivax c) Malariae d) Ovale Females of Anopheles species mosquito are the vectors of Malaria. They bite to obtain the blood meal necessary for the development of their own progeny. When the man is bitten by an infected mosquito, Sporozoites (10) are injected. These rapidly leave the circulation and enter hepaocytes, where are asexual multiplication occurs and the progeny, called merozoites (1) are relized into the circulation when the infected liver cells rupture. This merozoites enter red blood cells and become Trophozoites. At the beginning they have a ring form, but they enlarge to fill the center. The developing parasite feed on the hemoglobin and brown break down pigment called haemozoin is seen in the red cells The erythrocytes rupture, releasing the merozoites which then invade other red cells. This erythrocytic cycle is characteristically synchronous; it takes 48 hours to produce the infection and this determines the periocity of the clinical paroxysm o fever and chills in acute malaria. The malaria may also be contracted from infected blood transfusion an by syringes shared among intravenous drugs abusers. Transplacental infection is uncommon. Which are the Pathological changes? a) Lymphoreticular system. Hyperplasia of the lymphoreticular system : Esplenomegaly The sinusoids are congested with parasite red cells and haemozoin pigment is plentiful in splenic macrophages and Kupffer cells. Sinus histiocytosis is seen in the Lymphonode and spleen. b) Kidneys: the renal tubules are damaged circulating immuno complexes are commonly present in malaria and occur two types of Glomerulonephritis: Acute proliferative Glomerulonephritis Focal or diffuse membranous Glomerulonephritis

c) Cerebral Malaria In fatal cases the brain is congested, often with petechial hemorrhages in the subcortical white matter. Microscopically show mcrovascular congestion and large number of parasitized red blood cells sticking to the vascular endothelium. Changes include, pericapillary demyelination and pericapillary ring hemorrhages