Pathology Of Malaria Parasites

Parasitical Worms.com The clinical symptoms of malaria are caused by blood clones. The gametocytes only parasitize in red blood cells and wait for the opportunity to be absorbed by Anopheles mosquitoes to continue growing in the mosquitoes, giving germs to infect other healthy people.
As the parasite develops in red blood cells, malaria pigment waste (haemozoin) and other toxic substances (such as glucose phosphate isomerase) accumulate.
When schizophrenia breaks down, these substances enter the bloodstream and stimulate the macrophages and other cells to release cytokines and other soluble elements that cause fever and cold

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Malaria is cyclical with the time it takes to complete a cycle in the pharynx of the parasite. So Plasmodium ma; ariae with a 72-hour red blood cell cycle will cause malaria 2 days (1 day has malaria, 2 days later, there is no malaria) on the fourth day, Plasmodium vivax because there is The cycle in erythrocytes is 48 hours so there will be malaria cách days (Sunday fever: one day has malaria, the next day has no malaria, the third day there is malaria)
Particularly for Plasmodium falciparum, although the cycle in erythrocytes is 48 hours, it has been verified through in vitro culture (some authors say it is 36 - 48 hours), but in fact it often causes daily malaria; The reason is that in case of Plasmodium falciparum infection, there will be many "parasites" of parasites and thus will develop asynchronously in erythrocytes
In clinical practice, the cycle of malaria is only pronounced once the disease has been onset for days, then the development of parasites in the blood is synchronized and only shows the cycle of the attack. fever.



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For Plasmodium falciparum, the parasite's late stages of development (old, schizophrenia) rarely occur in peripheral blood, but are usually concentrated in visceral blood (also called sequestration).
At the same time, due to the presence of knobs on the surface of the red blood cells that are parasitic, it makes the parasitic red cells easily stick together (aggregation, rosetting) or stick to the walls of blood vessels ( cytoadherane) obstructs the blood circulation.
If it occurs in cerebral vessels, it will cause malignant brain malaria with coma. In pregnant women during the first 3 months, adhesion also occurs at the placenta (the parasite attaches to chondroitin sulfate A - CSA present in the placenta) damaging the fetus (death, miscarriage, weight when low birth . ).
The malaria parasite also causes severe anemia, especially in children and pregnant women. The cause is not only because of parasitic erythrocytes rupture, but also because macrophages not only "clean up" the parasitic red blood cells but the macrophages and destroy other normal red blood cells, or operate. of bone marrow disorder and inhibition leading to anemia.



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The spleen is also congested due to parasitic erythrocytes concentrated in capillaries, which gradually leads to the phenomenon of splenomegaly due to malaria. In the case of Plasmodium vivax infection, the spleen may swell quickly and may break.
In the case of severe malaria caused by Plasmodium falciparum, there may be hemorrhagic spots and even tubular necrosis leading to renal failure, or due to hemoglobin concentration in the renal tubules that causes hemolytic hyperemia, especially when treated with quinine.
Chronic Plasmodium malariae infection can cause nephrotic syndrome due to the accumulation of immune complexes and autoimmune processes against the glomerular basement membrane
Congenital malaria can also occur rarely. The cause is unknown but it may be due to the damage of the placenta.
Common form (malaria attack)
* Typical malaria: there are three stages: shivering - fever - sweating.
* Atypical malaria: non-seizure fever (chills, common cold in long-lived people in endemic areas), constant fever or fluctuations in the first 5 - 7 days and then an attack ( more common in children who have first had malaria).
Severe and complicated forms (malignant malaria)
Commonly caused by Plasmodium falciparum infection or in combination with Plasmodium falciparum (recent reports show that Plasmodium vivax can also cause malignant malaria), have one or more life-threatening complications, requiring recovery. positive energy.



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Table 1: Clinical and laboratory manifestations in malignant malaria patients.
Expression
How to know
Test
Conscious disorder
Glasgow <15 points for adults, Blantyre 3 mg / dl (> 265 µmol / L) in adults, and> 1.5 mg / dL (> 130 µmol / L in children.
Skin resurfacing (in combination with signs of liver dysfunction)
Yellow skin, golden eye conjunctiva
Bilirubin> 3mg / dL (> 50 µmol / L). Bilirubin directly and indirectly increased.
Shock (shock)
Cold person, bluish-purple skin, cold and damp, weak peripheral vessels, hypotension. Maximum blood pressure <80 mmHg in adults and children> 10 years old, <70 mmHg in p.

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