Fever and other febrile symptoms are the hallmarks of malaria. But it’s crucial to keep in mind that malaria is not just a simple illness characterised by fever, chills, and rigors. In a malaria dominant area, it can have a wide range of dramatic symptoms. As a result, doctors may need to rule out malaria as a possible diagnosis for almost all clinical issues. Particularly in areas where it is endemic, malaria is an excellent pathological imitator. This article lists the symptoms of malaria, explains why it causes fever, describes the pattern of fever in malaria, and discusses the patterns of fever linked to different plasmodium strains.
What are the clinical signs and symptoms of malaria?
Patients initially experience symptoms that resemble a ‘viral syndrome’, such as fever, chills, sweating, headaches, weakness, and other symptoms. Later, a severe illness could manifest itself with multiple organ failure, severe anaemia, abnormal levels of consciousness, and kidney damage.
Why does malaria cause fever?
The rupture of mature malaria parasites in the red blood cell stage can result in fever and chills if you have malaria. In cases of severe falciparum malaria, parasitised red cells can block capillaries and the structures that drain blood from the capillaries. This can result in the release of toxic cellular products and a local lack of oxygen, ultimately leading to a rise in the temperature. Besides that, cerebral malaria, which obstructs microcirculation in the brain and other crucial organs can be the root cause of severe complications.
What kind of pattern does malaria fever have?
It is unusual to find cases with the typical fever pattern in an endemic area. Some patients might not even have a fever and instead, display other signs and symptoms. Many individuals display fever in a variety of patterns, including low to high grade, intermittent to continuous, with or without chills, or even as cases of prolonged fever.
The emergence of multiple malaria parasite in the blood results in the fever developing every day, especially in the early stages of the illness, with more than one spike per day. As the illness progresses, these parasite strains organise themselves better, and the fever usually becomes more regular. P. falciparum malaria and mixed infections, however, may still show this pattern of multiple spikes.
What variations in fever patterns are brought on by various plasmodium strains?
P. malariae has a 72-hour cycle and manifests as fever every fourth day, followed by two days without fever. Tertian malaria refers to the fever outbursts that occur every third day in P. vivax and P. ovale, two parasites with 48-hour cycles. P. knowlesi has a 24-hour cycle and exhibits a daily fever. Depending on the timing and size of the broods, fever in a P. falciparum infection may occur every third day, more frequently, or even in a daily high-temperature pattern. This is the reason it is atypical in nature. P. malariae infections with other parasites can cause fever outbursts for two days in a row followed by one day of remission.
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