Malaria parasites and life cycle

Malaria parasites and life cycle

Malaria parasites and life cycle

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Malaria Species - The Parasite Posse

Plasmodium falciparum ring forms in a blood smear

  • P. falciparum: Most severe; irregular high fever. Infects all RBCs, high parasitemia. Multiple rings per RBC; banana-shaped gametocytes on peripheral smear.
  • P. vivax & P. ovale: Tertian fever (48-hr cycle). Infects reticulocytes. Schüffner's dots on microscopy.
  • P. malariae: Quartan fever (72-hr cycle). Infects senescent RBCs. Rosette schizonts.
  • P. knowlesi: Quotidian fever (24-hr cycle) in SE Asia. Can progress rapidly to severe disease.

P. vivax and P. ovale have a dormant liver stage (hypnozoites) that can cause relapses weeks to months later; requires treatment with primaquine.

Malarial Life Cycle - A Bug's Life

Malaria Parasite Life Cycle

  • Inoculation: Female Anopheles mosquito injects sporozoites into the human bloodstream.
  • Exo-erythrocytic (Liver) Stage:
    • Sporozoites travel to the liver and mature into schizonts.
    • Schizonts rupture, releasing merozoites.
    • 📌 P. vivax & P. ovale can form dormant hypnozoites, causing relapses.
  • Erythrocytic (Blood) Stage:
    • Merozoites infect RBCs, mature into ring-stage trophozoites, then schizonts.
    • RBCs lyse, releasing more merozoites, causing cyclical fever.
    • Some differentiate into gametocytes.

⭐ Cyclical fever patterns (e.g., 48-hour cycle for P. falciparum) are caused by the synchronous rupture of RBCs, releasing merozoites and inflammatory cytokines.

Clinical Features - Fever Pitch

  • Classic Paroxysm: Cyclical episodes of chills, high fever (>40°C), and profuse sweating.
  • Corresponds to the synchronous rupture of infected red blood cells (RBCs) by mature schizonts.
  • Prodrome: Non-specific flu-like symptoms (malaise, headache, myalgia) may precede fever spikes.

Species-Specific Fever Cycles:

  • Tertian (48-hr cycle):
    • P. vivax & P. ovale (Benign Tertian)
    • P. falciparum (Malignant Tertian): Often irregular or continuous due to multiple, asynchronous parasite broods.
  • Quartan (72-hr cycle): P. malariae
  • Quotidian (24-hr cycle): P. knowlesi

⭐ Initial malarial infections, especially with P. falciparum, often present with a chaotic, non-specific fever pattern before establishing a regular cycle.

Diagnosis - Blood Under the Scope

  • Gold Standard: Thick & thin blood smears (Giemsa stain).
    • Thick smear: Detects parasite presence (sensitive).
    • Thin smear: Identifies species & parasitemia (specific).
  • Key Findings:
    • P. falciparum: Multiple rings/RBC ("headphone" form), banana-shaped gametocytes. Affects all RBCs.
    • P. vivax/ovale: Enlarged RBCs (infects reticulocytes), Schüffner's dots.
    • P. malariae: Rosette schizonts, band-form trophozoites. Normal-sized RBCs.

High-grade parasitemia and crescent-shaped gametocytes

⭐ In P. falciparum, only ring forms and gametocytes are typically seen in peripheral blood due to sequestration of mature forms in the microvasculature.

High‑Yield Points - ⚡ Biggest Takeaways

  • Malaria is caused by Plasmodium species, transmitted by the female Anopheles mosquito.
  • P. falciparum is the most severe, causing irregular high fevers, cerebral malaria, and renal failure.
  • The life cycle alternates between a human and mosquito host, with sporozoites being the infective stage for humans.
  • Diagnosis relies on identifying parasites, like ring forms or gametocytes, on Giemsa-stained blood smears.
  • P. vivax and P. ovale have dormant liver hypnozoites, requiring treatment with primaquine.
  • Sickle cell trait and thalassemia offer protection against severe falciparum malaria.

Practice Questions: Malaria parasites and life cycle

Test your understanding with these related questions

An investigator is studying the outcomes of a malaria outbreak in an endemic region of Africa. 500 men and 500 women with known malaria exposure are selected to participate in the study. Participants with G6PD deficiency are excluded from the study. The clinical records of the study subjects are reviewed and their peripheral blood smears are evaluated for the presence of Plasmodium trophozoites. Results show that 9% of the exposed population does not have clinical or laboratory evidence of malaria infection. Which of the following best explains the absence of infection seen in this subset of participants?

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Flashcards: Malaria parasites and life cycle

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Plasmodium vivax/ovale present with multiple, brick-red dots in RBCs, known as _____ dots

TAP TO REVEAL ANSWER

Plasmodium vivax/ovale present with multiple, brick-red dots in RBCs, known as _____ dots

Schffner

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