Name: Iboro Favour Akpan

Mat no: U2018/4730016

Signs and symptoms and clinical manifestations of malaria parasite

Signs and symptoms of malaria may include:

● Fever
● Chills
● General feeling of discomfort
● Headache
● Nausea and vomiting
● Diarrhea
● Abdominal pain
● Muscle or joint pain
● Fatigue
● Rapid breathing
● Rapid heart rate
● Cough
Some people who have malaria experience cycles of malaria "attacks." An attack usually starts
with shivering and chills, followed by a high fever, followed by sweating and a return to normal
temperature.

Clinical manifestations
Malaria is a febrile illness with a wide range of clinical manifestations, from flu like symptoms
that may remain undiagnosed to severe malaria with seizures, coma and multiple organ failure.
Most of the clinical manifestations are due to individual immunity response (overproduction of
IL, TNF and othen cytokines) that is triggered mainly by the erythrocytic phase of the
plasmodium life cycle and the merozoites release in the bloodstream (parasitaemia).
Malaria may mimic other diseases and the symptoms may be atypical, fact that, in endemic
countries can lead to differential diagnosis dilemmas, while in non endemic countries may
confuse the clinicians that are not familiar with the disease.
Malaria disease can be categorized as uncomplicated or severe (complicated).

Uncomplicated malaria
Definition: symptomatic malaria without signs of severity or evidence of vital organ dysfunction.
The manifestations of uncomplicated disease are the following:
● Fever
● Chills
● Headache
● Dizziness
● Back pain
● Myalgia, joint and bone pains
● Cough, chest pain
● Weakness, prostration
 ● Gastrointestinal disturbances (nausea, vomiting, diarrhea)
The typical but infrequently observed malaria attack consists of three stages:
Cold stage (characterized by feeling of cold and shivering followed by whole body shaking that
lasts 15- 60 minutes, cold, dry and pale skin)
Hot stage (high fever up to 40- 41 oC that lasts 2- 6 hours, severe headache, palpitations,
tachypnoea, flushed and dry skin)
Sweating stage (profuse sweating for 2- 4 hours, feeling of exhaustion).

Severe (complicated) malaria

Definition: “the presence, in a patient with falciparum malaria, of clinical manifestations such as;
● Dehydration
● Circulatory collapse
● Electrolyte imbalances
● Hypoglycaemia
● Severe anaemia
● Spontaneous bleeding

Falciparum malaria complications:

Severe anemia
Severe anemia is one of the most important causes of malaria deaths, especially in African
countries. The mechanisms that lead to severe anemia are the following:

● Red cells rupture directly by parasites

● Reduced flexibility of the infected red blood cells that leads to their destruct.

Tropical splenomegaly syndrome

Tropical splenomegaly syndrome, known also as hyperreactive malarial splenomegaly, occurs
due to abnormal immunological hyper- stimulation of the human body as a result of repeated
infections. It is a very rare manifestation that occurs mainly in adults. The predominant
symptoms are: abdominal pain, presence of palpable mass, massive weight loss and
cachexia.Most of the time, there is a benign development of the disease but some patients may
suffer congestive heart failure due to severe anemia or may be susceptible to respiratory and
skin infections.