II. Epidemiology
-
Incidence
- Malaria is the most common life threatening disease for travelers
- Mosquito population is expected to as much as double with global warming (0.4 C) by 2020
- Europe and North America infections are typically due to travel
- European, North American traveler cases: 30,000/year
- U.S. Cases reported to CDC per year: 1500 to 2000 (out of 18 million U.S. travelers to Malaria endemic areas)
- Malaria was endemic to North America, but was eradicated in the mid-twentieth century
- Worldwide Infections: 300 million per year
- Children under age 5 years are disproportionally affected
- Worldwide Mortality: 500,000 deaths per year (some estimates have been as high as 1 to 3 Million per year)
- Malaria (esp. P. falciparum) is among the top three infectious causes of death in the world
- Other high mortality infectious causes include HIV Infection and Tuberculosis)
- Timing
- Majority of Malaria outbreaks occur between May and December
- Highest risk is during and after the rainy season
- River beds and stagnant pools of water are most common breading grounds
- Regions
- Endemic to tropical and subtropical world around the equator (106 countries as of 2010)
- Highest Risk
- Sub-Saharan Africa
- Papua New Guinea
- Solomon Islands
- Vanuatu
- Intermediate Risk
- Haiti
- Indian subcontinent
- Southeast Asia
- Low Risk
- Latin America
III. Pathophysiology
- See Vector-Borne Infection
- Transmitted by bite of female anopheline (or anopheles) Mosquito
- Usually bites between dusk and dawn
- Injects malaria Protozoa from Salivary Glands
- Other modes of human transmission (e.g. Blood Transfusion, congenital transmission) are rare
- Species of Malaria
- Plasmodium Falciparum (most common and most life threatening)
- Fulminant Malaria associated with high Parasitemia and intravascular congestion
- Incubation Period: Typically 12-14 days (ranges from 7 to 30 days)
- Responsible for most Malaria deaths
- Plasmodium Vivax
- Incubation Period: Months to years
- Plasmodium Malariae (Quartan Malaria)
- Fever recurs every 3 days (Quartan Fever), instead of the 2 day intervals of other Plasmodium
- Plasmodium Ovale
- Incubation Period: Months to years
- Plasmodium knowlesi
- Emerging pathogen in those exposed to macque monkeys
- Similar in appearance to p. Malariae
- Plasmodium Falciparum (most common and most life threatening)
- Life cycle of Malaria
- Injected from Mosquito as sporozoite
- Sporozoites invade hepatocytes in human liver
- Develop into merozoites after weeks to months of development within hepatocytes
- Merozoites released into blood stream
- Sporozoites may lie dormant in liver (hypnozoites)
- Occurs with Plasmodium Vivax and Plasmodium Ovale
- Symptoms recur when reactivates in months to years
- Merozoites invade erythrocytes and circulate freely
- P. Malariae may remain in Red Blood Cells without lysis, latent for months to years
- Typically results in Red Blood Cell lysis within 48-72 hours of erythrocyte invasion
- Hemolysis is associated with fever spikes
- Fever spikes typically occur randomly, but may occur with RBC lysis in a pattern
- May cause Tertian Fever (recurring every third day)
- May cause Quartan Fever (recurring every fourth day)
- Circulating merozoites differentiate into Gametocytes
IV. Precautions
- Fever in a returning traveler from Malaria endemic area is Malaria until proven otherwise
- Up to 50% of Malaria cases are misdiagnosed on the first visit
- Initial presentations are often mild and non-specific (fever, chills, malaise, myalgia, Headache)
- Malaria (esp. P falciparum) requires emergent evaluation
- Clinical decompensation or death may occur within 24 to 36 hours in a Malaria naive patient
V. Symptoms
- Timing
- Presentation within the first month of return from travel to endemic region
- Plasmodium Falciparum Incubation Period is typically 12 to 14 days (range 7 to 30 days)
- See Fever in the Returning Traveler for timing of other illnesses in the differential
- Delayed presentation beyond 2 months may occur with the use of chemoprophylaxis
- Plasmodiun ovale and Plasmodium Vivax may have delayed presentations, months later
- Presentation within the first month of return from travel to endemic region
- Initial prodrome
- Headache
- Malaise
- Next
- Fever (>50% of patients)
- Shaking chills
- Next
- Drowsiness
- Lethargy
- Fatigue
- Other symptoms
- Myalgias
- More severe in Dengue Fever
- Muscle tenderness
- More severe in Leptospirosis and Typhus
- Arthralgias
- Back pain
- Gastrointestinal Symptoms (may be isolated presentation in children)
- Myalgias
VI. Signs
- Fever for 1-8 hours
-
Fever recurs
- Plasmodium Vivax: 48 hour intervals (Tertian Fever)
- Plasmodium Malariae: 72 hour intervals (Quartan Fever)
- Plasmodium Falciparum: Variable
- Gastrointestinal findings (in <35-40% of cases)
- Tender Splenomegaly
- Severe Falciparum Malaria
- Hypotension and shock
- Multisystem failure
- Pulmonary Edema
- Acute Respiratory Distress Syndrome
- Renal Failure (1% of cases)
- Jaundice and liver failure (associated with poor prognosis)
- Cerebral Malaria
- Altered Mental Status to unresponsive
- Seizures
- Meningismus
VII. Differential Diagnosis
- See Fever in the Returning Traveler
- See Vector-Borne Infection
- Arboviruses are also Vector-Borne Infections (Aedes aegypti Mosquito-Borne Disease is common vector)
- Rash is uncommon in Malaria (aside from Petechiae in severe Falciparum Malaria with DIC) and suggests other diagnosis
- Other Bacterial Infections
- Other Viral Infections
- Other Parasitic Infections
- Leptospirosis
- Visceral Leishmaniasis
- African Trypanosomiasis
VIII. Labs
-
Blood Glucose
- Hypoglycemia may occur (esp. children)
-
Complete Blood Count (CBC) with differential
- Especially consider Malaria with Leukopenia and Left Shift, Thrombocytopenia
- Hemoglobin or Hematocrit consistent with Anemia (29%)
- Leukopenia with White Blood Cell Count <5000/mm3 (26%)
- Thrombocytopenia (45%)
- Bandemia (85%)
-
Urinalysis
- Urobilinogen positive
- Hemoglobinuria (rare, may occur with Plasmodium Falciparum)
-
Cerebrospinal Fluid Examination
- Indicated in Altered Mental Status and fever
- Exclude Meningitis and Encephalitis (esp. if Malaria diagnosis is unclear)
- Malaria CSF is typically normal (aside from mild CSF Pleocytosis, mild increased CSF Protein)
IX. Diagnosis
-
Peripheral Blood Smear
- Gold standard for diagnosis
- Stains
- Giemsa stain (reference standard stain for Malaria evaluation with thick and thin smears)
- Thin blood smear (first-line Malaria evaluation)
- Giemsa stain of blood fixed with Alcohol to prevent Red Blood Cell lysis
- Thin stain can identify Malaria species and quantify Parasitemia
- High Test Sensitivity
- Thick blood smear (perform if thin blood smear negative)
- Giemsa stain of blood allowed to dry on slide (allowing cell lysis)
- Thick stain evaluates for malaria Parasites in general
- Thin blood smear (first-line Malaria evaluation)
- Wright stain (standard stain for most Complete Blood Count associated manual differentials)
- Test Sensitivity approaches that of Giemsa stain
- Giemsa stain (reference standard stain for Malaria evaluation with thick and thin smears)
- Protocol
- Stat blood smear with direct communication with reading pathologist (alert for Malaria concern)
- Examine new smear every 12-24 hours for 2-3 days (low Parasitemia may require additional smears)
- Sample is best obtained when patient is febrile
- Image
- Rapid blood dipstick testing (when smear not available)
- Tests
- Binax-NOW (only detect P. falciparum and P. vivax; only FDA approved test in U.S.)
- HRP-2 detection (only detects P. falciparum)
- LDH detection (detects all 4 Malaria types)
- Benefits
- Good Test Sensitivity and Negative Predictive Value, yet easy to perform and does not require lab facility
- Results available within 5 to 20 minutes
- Precautions
- All rapid tests should be followed by blood smears
- Positive tests do not quantitate Parasitemia
- Negative rapid tests should be confirmed with blood smears
- Decreased Test Sensitivity with low levels of Parasitemia
- Examples: Patients who took chemoprophylaxis, or prior exposure
- All rapid tests should be followed by blood smears
- Tests
- Malaria PCR
- Detects low levels of parsites in blood (<5 Parasites/ul)
- Distinguishes between plasmodium species
- May be used to monitor response to treatment at 5-8 days (however False Positives may occur)
X. Management: Falciparum or Knowlesi Malaria or Severe Case and Unknown Species
- See CDC emergency contact information as below for Malaria management guidance
- Precautions
- Substandard and counterfeit antimalarial use is widespread in resource limited and low income countries
- Anti-Malarials Considered safe in Pregnancy
- Chloroquine
- Hydroxychloroquine
- Quinine
- Clindamycin
- Mefloquin
- Artemisinin Combination Therapy (ACT) safe in second and third trimester
- Artemether/Lumefantrine (Coartem) may be used in first trimester if no other reasonable option
- Hospital Admission Criteria
- Admit Falciparum Malaria and Knowlesi cases to hospital (high mortality in first 48 hours)
- Also admit all undiferentiated cases where species of Malaria cannot be discerned
- High Risk Cohorts
- Immunocompromised
- Malaria naive patients (no prior Malaria infections)
- Children
- Pregnancy
- Severe case criteria (any of the following)
- Glasgow Coma Scale (GCS) <11 or Coma
- Seizures
- Severe Anemia (Hemoglobin <7 g/dl in adults, <5 g/dl in children age <12 years)
- Acute Kidney Injury
- Hypoglycemia
- Acute Respiratory Distress Syndrome
- Shock
- Disseminated Intravascular Coagulation
- Acidosis
- Liver Dysfunction
- Parasite Density >5%
- Admit Falciparum Malaria and Knowlesi cases to hospital (high mortality in first 48 hours)
- Artemisinin Combination Therapy (ACT) Antiparasitic Agents (2 agents)
- Regimens based on severity (see above for severe case criteria)
- General Protocol
- Agent 1: Artemisinin (or dihydroartemisinin, artemether, or Artesunate) - first-line agent
- See Artesunate (preferred in U.S.)
- Artemisinin is contraindicated in first trimester of pregnancy
- Use oral formulation in non-severe cases, and intravenous formulation in severe cases
- Agent 2: Lumefantrine (see below), Chloroquine, Sulfadoxine-Pyrimethamine (Fansidar) or Mefloquine
- Treat for 3 days (6 days if travel to areas with high Malaria resistance)
- Agent 1: Artemisinin (or dihydroartemisinin, artemether, or Artesunate) - first-line agent
- Non-Severe Cases: Artemether/Lumefantrine (Coartem)
- Each tablet contains 20 mg Artemether (an Artemisinin) and 120 mg Lumefantrine
- Tablets may be crushed and mixed with 10 ml water if unable to swallow tablets (e.g. children)
- Tablets are best absorbed with high fat foods
- Repeat dose if Vomiting occurs within 2 hours of dose
- Each dose based on weight
- Children 5 kg to 15 kg: 1 tablet per dose
- Children 15 kg to 25 kg: 2 tablets per dose
- Children 25 kg to 35 kg: 3 tablets per dose
- Children >35 kg and Adults: 4 tablets per dose
- Dosing (3 day course, with doses per weight as above)
- Give one dose every 8 hours for 2 doses on day 1, then one dose every 12 hours on days 2 and 3
- Each tablet contains 20 mg Artemether (an Artemisinin) and 120 mg Lumefantrine
- Severe Cases: Intravenous Artemisinin (Artesunate is preferred)
- Indicated in severe cases (see criteria above), including Parasite load >5%
- Start immediately at the time of diagnosis
- Artesunate 2.4 mg/kg at start, 12 and 24 hours, then daily until Parasitemia <1% (up to 7 days)
- Obtain blood smear Parasite stains for density every 12 hours
- Other agents when Artemisinin Combination Therapy (ACT) is unavailable
- Chloroquine sensitive regions
- Chloroquine
- Adults
- Load: 1000 mg salt (600 mg base) orally at start
- Maintenance: 500 mg salt (300 mg base) orally at 6 hours, 24 hours and 48 hours after initial dose
- Child
- Load: 16.7 mg/kg salt (10 mg/kg base) orally at start
- Maintenance: 8.3 mg/kg salt (5 mg/kg base) orally at 6 hours, 24 hours and 48 hours after initial dose
- Adults
- Hydroxychloroquine (Plaquenil)
- Adult: 800 mg salt (620 mg base) to start, then 400 mg salt (310 mg base) at 6, 24 and 48 hours after initial dose
- Child: 12.9 mg/kg salt (10 mg/kg base) to start, then 6.5 mg/kg salt (5 mg/kg mg base) at 6, 24 and 48 hours after initial dose
- Chloroquine
- Chloroquine resistant regions
- Atovaquone/Proguanil (Malarone)
- See Atovaquone for dosing
- Quinine-based protocols (2 agents)
- General
- Avoid in severe disease
- Use 7 day course if acquired in Southeast Asia
- Quinine 10 mg/kg up to 648 mg salt (8.3 mg/kg up to 542 mg base) three times daily orally for 3 to 7 days AND
- Second Agent
- Doxycycline 2.2 mg/kg up to 100 mg orally twice daily for 7 days (or Tetracycline) OR
- Clindamycin (if Tetracyclines contraindicated) 20 mg/kg orally for 3 to 7 days
- General
- Mefloquine (other options are preferred)
- Adult: 750 mg salt (684 mg base) for first dose, then second dose of 500 mg salt (456 mg base) in 6 to 12 hours
- Child: 15 mg/kg salt (13.7 mg/kg base) for first dose, then second dose of 10 mg/kg salt (9.1 mg/kg base) in 6 to 12 hours
- Atovaquone/Proguanil (Malarone)
- Chloroquine sensitive regions
- Plasmodium Malariae and Plasmodium knowlesi
- Artemisinin Combination Therapy (ACT) is recommended despite lack of Chloroquine resistance (see protocol below)
- Admit all Plasmodium knowlesi cases (high risk for severe disease)
- Following Initial Treatment: Plasmodium Ovale or Plasmodium Vivax (risk of relapsing infection)
- Risk of dormant Malaria (due to hypnozoites) and relapsing infection
- Follow initial course with following therapies to prevent relapsing infection
- Mothers infected with P. vivax or P. ovale during pregnancy
- Test infants for G6PD Deficiency after delivery
- Mothers should Breast feed and take either Primaquine (No G6PD Deficiency) or Chloroquine (G6PD deficient)
- No G6PD Deficiency
- Primaquine
- Adult: 52.6 mg salt (30 mg base) orally daily for 14 days after initial course
- Child: 0.8 mg/kg salt (0.5 mg/kg base up to 30 mg/day) orally daily for 14 days after initial course
- Decrease dose if Tinnitus or hyperexcitability occur
- Tafenoquine
- Adult (>age 16 years): 300 mg orally once after first or second day following Chloroquine course
- Contraindicated age <16 years or Psychotic Disorder
- Use only if Chloroquine or Hydroxychloroquine were used to treat initial infection
- Primaquine
- G6PD Deficiency
- Continue Chloroquine prophylaxis 500 mg salt (300 mg base) dosed weekly for one year OR
- Primaquine may be considered if G6PD is mild or intermediate
- Consult infectious disease
- Risk of dormant Malaria (due to hypnozoites) and relapsing infection
- Specific complication management
- Shock
- Intravenous hydration (including fluid boluses)
- Obtain Blood Cultures and add Third Generation Cephalosporin to regimen
- Cerebral Malaria (18% of cases)
- Seizures
- Supportive care including intubation may be needed
- Meningism (uncommon but carries 23% mortality)
- Bleeding
- Coagulopathy reversal
- Blood Transfusion
- Shock
- Other non-specific management
- Intravenous Fluids
- Antipyretics
- Antiemetics
- Follow-up
- Evaluate for Hemolytic Anemia at 30 days after treatment of severe cases
XI. Prevention
- See Prevention of Vector-borne Infection
- Malaria Chemoprophylaxis is critical and not taken adequately in as many as 75% of U.S. travelers
- Malaria Vaccine
- WHO has recommended use for Malaria falciparum prevention in children
- Vaccination initiated in 2021 in Ghana, Malawi and Kenya (>1 million doses administered as of 2022)
- Alonso (2022) N Engl J Med 386(11): 1005-7 [PubMed]
- Stay in air conditioned or well screened rooms
- Reduce nighttime outdoor activity (Dusk until dawn)
- Apply an effective Insect Repellent
- DEET 20 to 30% to skin every 3-4 hours or
- Picaridin 20% or
- p-Menthane-3,8-diol (PMD, Menthoglycol)
- Spray clothing and bed nets with Permethrin
- Wear long sleeve shirt and pants
- Use Insecticide aerosols at dusk in living areas
- Use a strong fan at bedside
- Use Mosquito bed netting even in hotel rooms
- Mosquito net pre-treated with Permethrin
- Reapply Permethrin every 6 months
XII. Complications
- Encephalopathy
- Hypoglycemia
- Acute Renal Failure
- Hepatic Dysfunction
- Pulmonary Edema
- Disseminated Intravascular Coagulation
- Hemolytic Anemia
- Shock
XIII. Prognosis
- Plasmodium Falciparum Mortality: 4% (20% in severe cases)
- More severe cases in children and pregnant women
XIV. Resources
- See Travel Resources
- CDC Malaria hotline (health care professionals)
- https://www.cdc.gov/parasites/contact.html
- Phone: 770-488-7788 (daytime, Monday to Friday, 9 am to 5 pm Eastern Standard Time)
- Phone: 855-856-4713 (daytime, toll free)
- Phone: 770-488-7100 (after hours, emergency operations center, ask to speak with DPDM expert)
- CDC Malaria Information
- Malaria Foundation International
XV. References
- Anderson (2014) Crit Dec Emerg Med 28(7): 11-9
- Black, Martin, DeVos (2018) Crit Dec Emerg Med 32(8): 3-12
- Mason and Marsh in Herbert (2019) EM:Rap 19(5):12-3
- Nordurft-Froman and DeVos (2022) Crit Dec Emerg Med 36(4): 4-15
- Baird (1999) Med Clin North Am 83(4):923-44 [PubMed]
- Croft (2000) BMJ 321(7254):154-60 [PubMed]
- Feder (2013) Am Fam Physician 88(8): 524-30 [PubMed]
- Johnson (2012) Am Fam Physician 85(10): 973-7 [PubMed]
- Lo Re (2003) Am Fam Physician 68(3):509-16 [PubMed]
- Shahbodaghi (2022) Am Fam Physician 106(3): 270-8 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
Definition (MSHCZE) | Onemocnění zapříčiněné u lidí čtyřmi druhy prvoka rodu PLASMODIUM: PLASMODIUM FALCIPARUM; PLASMODIUM VIVAX; PLASMODIUM OVALE a PLASMODIUM MALARIAE. Je šířené kousnutím nakaženého samičího komára rodu ANOPHELES. Malárie se vyskytuje v částech Asie, Afriky, střední a jižní Ameriky, Oceánie a v některých částech karibských ostrovů. Charakterizuje ji značné vyčerpání spojené s návaly vysoké horečky, pocení, třesavkou, a chudokrevností. Malárie u zvířat je způsobena jinými druhy plasmódií. |
Definition (MEDLINEPLUS) |
Malaria is a serious disease caused by a parasite. You get it when an infected mosquito bites you. Malaria is a major cause of death worldwide, but it is almost wiped out in the United States. The disease is mostly a problem in developing countries with warm climates. If you travel to these countries, you are at risk. There are four different types of malaria caused by four related parasites. The most deadly type occurs in Africa south of the Sahara Desert. Malaria symptoms include chills, flu-like symptoms, fever, vomiting, diarrhea, and jaundice. A blood test can diagnose it. It can be life-threatening. However, you can treat malaria with drugs. The type of drug depends on which kind of malaria you have and where you were infected. Malaria can be prevented. When traveling to malaria-prone regions
Centers for Disease Control and Prevention |
Definition (NCI) | A protozoan infection caused by the genus Plasmodium. There are four species of Plasmodium that can infect humans: Plasmodium falciparum, vivax, ovale, and malariae. It is transmitted to humans by infected mosquitoes. Signs and symptoms include paroxysmal high fever, sweating, chills, and anemia. |
Definition (CSP) | protozoan disease caused in humans by four species of the genus Plasmodium (P. falciparum, P. vivax, P. ovale, and P. malariae) and transmitted by the bite of an infected female mosquito of the genus Anopheles; malaria is endemic in parts of Asia, Africa, Central and South America, Oceania, and certain Caribbean islands; characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia; malaria in animals is caused by other species of plasmodia. |
Definition (MSH) | A protozoan disease caused in humans by four species of the PLASMODIUM genus: PLASMODIUM FALCIPARUM; PLASMODIUM VIVAX; PLASMODIUM OVALE; and PLASMODIUM MALARIAE; and transmitted by the bite of an infected female mosquito of the genus ANOPHELES. Malaria is endemic in parts of Asia, Africa, Central and South America, Oceania, and certain Caribbean islands. It is characterized by extreme exhaustion associated with paroxysms of high FEVER; SWEATING; shaking CHILLS; and ANEMIA. Malaria in ANIMALS is caused by other species of plasmodia. |
Concepts | Disease or Syndrome (T047) |
MSH | D008288 |
ICD9 | 084.6, 084 |
ICD10 | B54 |
SnomedCT | 187510004, 154374002, 186797008, 61462000, 248437004, 105649009 |
LNC | LA10488-7 |
English | Infection, Plasmodium, Infections, Plasmodium, Plasmodium Infection, Plasmodium Infections, MALARIA, Malaria, unspecified, Unspecified malaria, [X]Unspecified malaria, PLASMODIUM INFECT, INFECT PLASMODIUM, malaria (diagnosis), malaria, Plasmodia infections, Malaria NOS, Malaria [Disease/Finding], malarial fever, malarias, paludism, fever malaria, malaria fever, [X]Unspecified malaria (disorder), Plasmodium infection, Unspecified malaria (disorder), Plasmodiosis, Malarial fever, Disease due to Plasmodiidae (disorder), Disease due to Plasmodiidae, Malaria (disorder), Malarial fever (finding), corsican; fever, fever; Cameroon, fever; corsican, fever; jungle fever, fever; jungle, fever; paludal, jungle fever; fever, jungle; fever, marsh fever, Cameroon fever, Cameroon; fever, paludal; fever, Corsican fever, Malaria, NOS, Paludism, Malaria, Malaria fever NOS, Fever, Marsh, Fever, Remittent, Marsh Fever, Remittent Fever |
French | PALUDISME, Infection à Plasmodium, Paludisme, non précisé, Paludisme SAI, Paludisme, Malaria, Infections à Plasmodium |
Portuguese | MALARIA, Malária NE, Infecção por Plasmodium, Febre Malárica, Impaludismo, Doença Malárica, Fiebre Remitente na Malária, Infecção Malárica, Febre da Malária, Maleita, Paludismo, Infecções por plasmódios, Infecções por Plasmodium, Malária, Febre Remitente Paludosa, Febre do Mangue |
German | MALARIA, Plasmodium Infektion, Malaria, unspezifisch, Malaria NNB, Paludismus, Malaria, nicht naeher bezeichnet, Plasmodien-Infektionen, Malaria, Plasmodium-Infektionen |
Italian | Infezioni da Plasmodi, Malaria NAS, Malaria non specificata, Infezione da Plasmodium, Paludismo, Malaria |
Dutch | malaria NAO, malaria, niet-gespecificeerd, paludisme, Corsica; koorts, Kameroen; koorts, fever; jungle, jungle fever; koorts, jungle; fever, koorts; Corsica, koorts; Kameroen, koorts; jungle fever, koorts; moeras, moeras; koorts, Niet gespecificeerde malaria, Plasmodia-infecties, malaria, Malaria, Plasmodium-infectie |
Spanish | Paludismo NEOM, Paludismo no especificado, Infección por plasmodium, paludismo no especificado, [X]paludismo no especificado, [X]paludismo no especificado (trastorno), malaria no especificada, paludismo no especificado (trastorno), Paludismo, Fiebre Malárica, enfermedad causada por Plasmodiidae (trastorno), enfermedad causada por Plasmodiidae, fiebre palúdica (hallazgo), fiebre palúdica, malaria (trastorno), malaria, paludismo (trastorno), paludismo, plasmodiosis, Infecciones por plasmodium, Infecciones por Plasmodium, Malaria, Fiebre Remitente, Fiebre de los Marjales |
Japanese | マラリアNOS, マラリア原虫感染, マラリア、詳細不明, マラリアNOS, マラリアショウサイフメイ, マラリア, マラリアゲンチュウカンセン, Plasmodium属感染症, マラリア, マラリア原虫感染症 |
Swedish | Malaria |
Czech | Plasmodium - infekce, zimnice bahenní, malárie, Paludismus, Malárie, Malárie NOS, Infekce způsobená plasmodiemi, Malárie, blíže neurčená, Plasmodiové infekce, střídavka |
Finnish | Malaria |
Russian | PLASMODIUM-INFEKTSII, MALIARIIA, PLASMODIUM-ИНФЕКЦИИ, МАЛЯРИЯ |
Korean | 상세불명의 말라리아 |
Croatian | MALARIJA |
Polish | Malaria, Zarażenie Plazmodium, Zimnica |
Hungarian | Paludismus, Plasmodium fertőzések, malaria k.m.n., Malaria, nem meghatározott, Plasmodium fertőzés, malaria |
Norwegian | Malaria |
Ontology: Malaria, Falciparum (C0024535)
Definition (MSH) | Malaria caused by PLASMODIUM FALCIPARUM. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations. |
Concepts | Disease or Syndrome (T047) |
MSH | D016778 |
ICD9 | 084.0 |
ICD10 | B50.9 , B50 |
SnomedCT | 187504004, 186802002, 62676009, 248441000 |
English | Malaria, Falciparum, Malaria, Plasmodium falciparum, Plasmodium falciparum Malaria, Falciparum malaria (malignant tertian), MTM - Malig tertian malaria, Plasmod falcprm malari,unsp, Plasmodium falciparum malaria, unspecified, [X]Plasmod falcprm malari,unsp, [X]Plasmodium falciparum malaria, unspecified, malaria due to plasmodium falciparum (diagnosis), malaria due to Plasmodium falciparum, Plasmodium falciparum malaria, Malaria, Falciparum [Disease/Finding], falciparum malaria, malaria falciparum, plasmodium falciparum malaria, [X]Plasmodium falciparum malaria, unspecified (disorder), Malignant tertian malaria, Falciparum malaria, Malaria by Plasmodium falciparum, Subtertian malaria, Falciparum malaria - malignant, MT - Malignant tertian malaria, MTM - Malignant tertian malaria, Pernicious malaria, ST - Subtertian malaria, STM - Subtertian malaria, Malignant tertian fever, Falciparum malaria (disorder), Malignant tertian fever (finding), Plasmodium; falciparum, estivo-autumnal; malaria, falciparum; malarial, malaria; Plasmodium falciparum, malaria; estivo-autumnal, malaria; malignant, malaria; subtertian, malaria; tertian, malignant, malaria; tropica, malignant; malarial, subtertian; malarial, Falciparum Malaria, Falciparum malaria [malignant tertian], Malaria fever by Plasmodium falciparum, Malaria fever, subtertian, Malaria subtertian |
Dutch | malaria falciparium, malaria falciparum (tertiana maligna), Plasmodium; falciparum, estivo-autumnale; malaria, falciparum; malaria, malaria; Plasmodium falciparum, malaria; estivo-autumnale, malaria; maligna, malaria; subtertiana, malaria; tertiana, maligna, malaria; tropica, maligna; malaria, subtertiana; malaria, Malaria door Plasmodium falciparum, niet gespecificeerd, Malaria door Plasmodium falciparum, Malaria tropica, Plasmodium-falciparummalaria |
French | Falciparum malaria, Paludisme à falciparium (fièvre tierce maligne), Paludisme à Plasmodium falciparum |
German | Falciparum-Malaria (boesartig tertiana), Falciparum-Malaria, Malaria tropica durch Plasmodium falciparum, Malaria tropica, nicht naeher bezeichnet, Malaria, Falciparum-, Plasmodium-falciparum-Malaria |
Italian | Malaria terzana maligna, Malaria da Plasmodium falciparum [terzana maligna], Malaria da Plasmodium falciparum |
Portuguese | Malária falciparum, Malária falciparum (terçã maligna), Malária Falciparum, Malária por Plasmodium Falciparum |
Spanish | Paludismo por P. Falciparum, Paludismo por Plasmodium falciparum (terciana maligna), [X]paludismo por Plasmodium falciparum, no especificado (trastorno), [X]paludismo por Plasmodium falciparum, no especificado, Paludismo por Plasmodium Falciparum, Paludismo Falciparum, fiebre terciana maligna (hallazgo), fiebre terciana maligna, malaria por Plasmodium falciparum, paludismo falciparum (trastorno), paludismo falciparum, paludismo pernicioso, paludismo por Plasmodium falciparum (trastorno), paludismo por Plasmodium falciparum, paludismo subterciano, paludismo terciano maligno, Malaria Falciparum, Malaria por Plasmodium Falciparum |
Japanese | 熱帯熱マラリア(悪性三日熱), ネッタイネツマラリアアクセイミッカネツ, ネッタイネツマラリア, 悪性三日熱マラリア, マラリア-熱帯熱, 夏秋期マラリア, 熱帯マラリア, 熱帯熱マラリア |
Swedish | Falciparummalaria |
Czech | malárie falciparum, Malárie způsobená Plasmodium falciparum, Malárie způsobená Plasmodium falciparum (maligní malárie terciána) |
Finnish | Falciparum-malaria |
Russian | MALIARIIA MOLNIENOSNAIA, PLASMODIUM FALCIPARUM MALIARIIA, MALIARIIA MOLNIENOSNAIA TREKHDNEVNAIA, PLASMODIUM FALCIPARUM МАЛЯРИЯ, МАЛЯРИЯ МОЛНИЕНОСНАЯ, МАЛЯРИЯ МОЛНИЕНОСНАЯ ТРЕХДНЕВНАЯ |
Korean | 열대열 말라리아, 상세불명의 열대열 말라리아 |
Polish | Zimnica złośliwa, Zimnica tropikalna, Zimnica Plasmodium falciparum |
Hungarian | Falciparum malaria (malignus tertiana), Falciparum malaria |
Norwegian | Not Translated[Malaria, Falciparum] |
Ontology: Quartan malaria (C0024536)
Concepts | Disease or Syndrome (T047) |
ICD9 | 084.2 |
ICD10 | B52 , B52.9 |
SnomedCT | 27618009 |
German | Malaria quartana durch Plasmodium malariae, Malaria quartana |
English | malaria due to plasmodium malariae (diagnosis), Plasmodium malariae malaria, malaria due to Plasmodium malariae, Plasmodium malariae malaria NOS, Malariae malaria, Quartan malaria, Malaria by Plasmodium malariae, Quartan malaria (disorder), Plasmodium; malariae, malaria; Plasmodium malariae, malaria; malariae, malaria; quartan, malariae; malarial, quartan; malarial, Quartan Malaria |
Korean | 사일열 말라리아 |
Spanish | paludismo cuarto, paludismo malariae, paludismo cuarto (trastorno), paludismo cuartano, paludismo cuartano (trastorno), malaria cuartana, Paludismo cuartano, malaria por Plasmodium malariae |
Czech | Malárie čtyřdenní, kvartána |
Dutch | malaria quartana, Plasmodium; malariae, malaria; Plasmodium malariae, malaria; malariae, malaria; quartana, malariae; malaria, quartana; malaria, Malaria door Plasmodium malariae |
French | Fièvre quarte |
Hungarian | malaria quartana |
Italian | Malaria quartana |
Japanese | ヨッカネツマラリア, 四日熱マラリア |
Portuguese | Malária quartã |
Ontology: Malaria, Vivax (C0024537)
Definition (MSH) | Malaria caused by PLASMODIUM VIVAX. This form of malaria is less severe than MALARIA, FALCIPARUM, but there is a higher probability for relapses to occur. Febrile paroxysms often occur every other day. |
Concepts | Disease or Syndrome (T047) |
MSH | D016780 |
ICD9 | 084.1 |
ICD10 | B51 , B51.9 |
SnomedCT | 27052006 |
English | Malaria, Plasmodium vivax, Malaria, Vivax, Plasmodium vivax Malaria, malaria due to plasmodium vivax (diagnosis), Plasmodium vivax malaria, malaria due to Plasmodium vivax, Plasmodium vivax malaria NOS, Malaria, Vivax [Disease/Finding], vivax malaria, malaria vivax, malaria plasmodium vivax, Tertian malaria, Vivax malaria (benign tertian), Benign tertian malaria, Malaria by Plasmodium vivax, Vivax malaria, BT - Benign tertian malaria, BTM - Benign tertian malaria, Vivax malaria - benign tertian, Vivax malaria (disorder), Plasmodium; vivax, malaria; Plasmodium vivax, malaria; tertian, malaria; vivax, tertian; malarial, vivax; malarial, Vivax Malaria, Vivax malaria [benign tertian] |
Swedish | Vivaxmalaria |
Czech | malárie vivax, Malárie způsobená Plasmodium vivax, Malária třídenní, terciána, Malárie způsobená Plasmodium vivax (benigní malárie terciána) |
Finnish | Vivax-malaria |
Russian | PLASMODIUM VIVAX MALIARIIA, MALIARIIA TREKHDNEVNAIA, PLASMODIUM VIVAX МАЛЯРИЯ, МАЛЯРИЯ ТРЕХДНЕВНАЯ |
German | Malaria tertiana durch Plasmodium vivax, Malaria vivax, Malaria vivax (gutartige tertiana), Malaria tertiana, Malaria, Vivax-, Plasmodium-vivax-Malaria |
Japanese | マラリア-三日熱, 三日熱マラリア(良性三日熱), ミッカネツマラリアリョウセイミッカネツ, ミッカネツマラリア, 三日熱マラリア |
Korean | 삼일열 말라리아 |
Polish | Zimnica Plasmodium vivat, Zimnica trzeciaczka, Malaria Plasmodium vivat |
Dutch | malaria vivax (tertiana benigna), malaria tertiana, vivax malaria, Plasmodium; vivax, malaria; Plasmodium vivax, malaria; tertiana, malaria; vivax, tertiana; malaria, vivax; malaria, Malaria door Plasmodium vivax, Malaria tertiana, Plasmodium-vivaxmalaria |
French | Paludisme tierce, Vivax malaria, Paludisme à vivax (fièvre tierce bénigne), Paludisme à Plasmodium vivax |
Hungarian | Vivax malaria (benignus tertian), Vivax malaria, Tercier malaria |
Italian | Malaria vivax [terzana benigna], Malaria terzana, Malaria da Plasmodium vivax |
Portuguese | Malária vivax, Malária vivax (terçã benigna), Malária terçã, Malária por Plasmodium Vivax, Malária Vivax |
Spanish | Paludismo por P. Vivax, Paludismo terciano, Paludismo por Plasmodium vivax (terciana benigna), Paludismo por Plasmodium Vivax, Paludismo Vivax, malaria por Plasmodium vivax, paludismo por Plasmodium vivax (trastorno), paludismo por Plasmodium vivax, paludismo terciano benigno, paludismo vivax (trastorno), paludismo vivax, Malaria por Plasmodium Vivax, Malaria Vivax |
Ontology: Plasmodium falciparum (C0032150)
Definition (MSHCZE) | Původce tropické malárie, má nevýraznou periodicitu schizogonie. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ ) |
Definition (MSH) | A species of protozoa that is the causal agent of falciparum malaria (MALARIA, FALCIPARUM). It is most prevalent in the tropics and subtropics. |
Definition (CSP) | species of protozoa that is the causal agent of falciparum malaria; it is most prevalent in the tropics and subtropics. |
Concepts | Eukaryote (T204) |
MSH | D010963 |
SnomedCT | 30020004 |
LNC | LP14839-2 |
Swedish | Plasmodium falciparum |
English | Plasmodium (Laverania) falciparum, falciparum, Plasmodium, Plasmodium falciparums, falciparums, Plasmodium, falciparum plasmodium, plasmodium falciparum, Pf - Plasmodium falciparum, Plasmodium falciparum (organism), Plasmodium falciparum |
Czech | Plasmodium falciparum |
Finnish | Plasmodium falciparum |
Russian | PLAZMODII SERPOVIDNYI, PLASMODIUM FALCIPARUM, ПЛАЗМОДИЙ СЕРПОВИДНЫЙ |
Polish | Zarodziec sierpowy, Plasmodium falciparum |
Norwegian | Plasmodium falciparum |
Spanish | Plasmodium falciparum (organismo), Plasmodium falciparum |
French | Plasmodium falciparum |
German | Plasmodium falciparum |
Italian | Plasmodium falciparum |
Dutch | Plasmodium falciparum, Tropicaparasiet |
Portuguese | Plasmodium falciparum |
Ontology: Plasmodium malariae (C0032153)
Definition (MSHCZE) | Původce malárie – kvartány (tzv. čtvrtodenní malárie). (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ ) |
Definition (MSH) | A protozoan parasite that occurs primarily in subtropical and temperate areas. It is the causal agent of quartan malaria. As the parasite grows it exhibits little ameboid activity. |
Concepts | Eukaryote (T204) |
MSH | D010965 |
SnomedCT | 56395006 |
LNC | LP17106-3 |
Swedish | Plasmodium malariae |
Czech | Plasmodium malariae |
Finnish | Plasmodium malariae |
Russian | PLAZMODII MALIARII, MALIARIINYI PLAZMODII, PLASMODIUM MALARIAE, МАЛЯРИЙНЫЙ ПЛАЗМОДИЙ, ПЛАЗМОДИЙ МАЛЯРИИ |
English | malariae, Plasmodium, PLASMODIUM MALARIAE, Pm - Plasmodium malariae, Plasmodium malariae (organism), Plasmodium malariae |
Polish | Plasmodium malariae |
Norwegian | Plasmodium malariae |
Spanish | Plasmodium malariae (organismo), Plasmodium malariae |
French | Plasmodium malariae |
German | Plasmodium malariae |
Italian | Plasmodium malariae |
Dutch | Plasmodium malariae, Quartanaparasiet |
Portuguese | Plasmodium malariae |
Ontology: Plasmodium vivax (C0032154)
Definition (MSHCZE) | původce malárie – terciány. Může mít poměrně dlouhou inkubační dobu. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ ) |
Definition (MSH) | A protozoan parasite that causes vivax malaria (MALARIA, VIVAX). This species is found almost everywhere malaria is endemic and is the only one that has a range extending into the temperate regions. |
Concepts | Eukaryote (T204) |
MSH | D010966 |
SnomedCT | 74746009 |
LNC | LP14841-8 |
Swedish | Plasmodium vivax |
Czech | Plasmodium vivax |
Finnish | Plasmodium vivax |
Russian | PLAZMODII VIVAKS, PLASMODIUM VIVAX, ПЛАЗМОДИЙ ВИВАКС |
English | Plasmodium vivaxs, vivax, Plasmodium, vivaxs, Plasmodium, plasmodium vivax, Pv - Plasmodium vivax, Plasmodium vivax (organism), Plasmodium vivax |
Polish | Plasmodium vivax, Zarodziec ruchliwy, Zarodziec żwawy |
Norwegian | Plasmodium vivax |
Spanish | Plasmodium vivax (organismo), Plasmodium vivax |
French | Plasmodium vivax |
German | Plasmodium vivax |
Italian | Plasmodium vivax |
Dutch | Plasmodium vivax, Tertianaparasiet |
Portuguese | Plasmodium vivax |
Ontology: Ovale malaria (C0152072)
Concepts | Disease or Syndrome (T047) |
ICD9 | 084.3 |
ICD10 | B53.0 |
SnomedCT | 19341001 |
English | Plasmodium ovale malaria, malaria due to plasmodium ovale (diagnosis), malaria due to Plasmodium ovale, Malaria by Plasmodium ovale, Ovale tertian malaria, Ovale malaria (disorder), Plasmodium; ovale, malaria; Plasmodium ovale, malaria; ovale, ovale; malarial, Ovale malaria, Malaria fever by Plasmodium ovale, Malariaby Plasmodium ovale |
German | Malaria durch Plasmodium ovale, ovale Malaria |
Korean | 난형열 원충 말라리아 |
Czech | Malárie způsobená P. ovale |
Dutch | malaria ovale, Plasmodium; ovale, malaria; Plasmodium ovale, malaria; ovale, ovale; malaria, Malaria door Plasmodium ovale |
French | Paludisme à Plasmodium ovale |
Hungarian | Ovale malaria |
Italian | Malaria ovale |
Japanese | 卵形マラリア, ランケイマラリア |
Portuguese | Malária a Plasmodium ovale |
Spanish | Paludismo por Plasmodium ovale, malaria por Plasmodium ovale, paludismo oval (trastorno), paludismo oval, paludismo por Plasmodium ovale (trastorno), paludismo por Plasmodium ovale |
Ontology: Plasmodium ovale (C0320744)
Definition (MSHCZE) | Původce malárie podobné terciáně. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ ) |
Definition (MSH) | A species of protozoan parasite causing MALARIA. It is the rarest of the four species of PLASMODIUM infecting humans, but is common in West African countries and neighboring areas. |
Concepts | Eukaryote (T204) |
MSH | D041122 |
SnomedCT | 18508006 |
LNC | LP17139-4 |
Swedish | Plasmodium ovale |
Czech | Plasmodium ovale |
Finnish | Plasmodium ovale |
English | Plasmodium ovales, ovale, Plasmodium, ovales, Plasmodium, Plasmodium ovale Stephens 1932, Po - Plasmodium ovale, Plasmodium ovale (organism), Plasmodium ovale |
Polish | Plasmodium ovale |
Norwegian | Plasmodium ovale |
Spanish | Plasmodium ovale (organismo), Plasmodium ovale |
French | Plasmodium ovale |
German | Plasmodium ovale |
Italian | Plasmodium ovale |
Russian | PLASMODIUM OVALE |
Dutch | Plasmodium ovale |
Portuguese | Plasmodium ovale |
Ontology: Tertian fever (C0424773)
Concepts | Finding (T033) |
SnomedCT | 248440004 |
Spanish | fiebre terciana, fiebre terciana (hallazgo), fiebr terciana (hallazgo), fiebr terciana |
English | tertian fever (physical finding), tertian fever, Tertian fever, Tertian fever (finding) |
Ontology: Quartan fever (C0424775)
Concepts | Finding (T033) |
SnomedCT | 248442007 |
English | quartan fever, quartan fever (physical finding), Quartan fever, Quartan fever (finding) |
Spanish | fiebre cuartana (hallazgo), fiebre cuartana |
Ontology: Plasmodium falciparum infection (C0858318)
Concepts | Disease or Syndrome (T047) |
Italian | Infezione da Plasmodium falciparum, Plasmodium falciparum |
English | Plasmodium falciparum infection, P.falciparum, p falciparum, p.falciparum |
Dutch | P. falciparum, Plasmodium falciparum-infectie |
French | P.falciparum, Infection à Plasmodium falciparum |
German | P. falciparum, Infektion durch Plasmodium falciparum |
Portuguese | P. falciparum, Infecção por pasmodium falciparum |
Spanish | P falciparum, Infección por Plasmodium falciparum |
Japanese | 熱帯熱マラリア原虫感染, 熱帯熱マラリア原虫, ネッタイネツマラリアゲンチュウカンセン, ネッタイネツマラリアゲンチュウ |
Czech | Infekce způsobená Plasmodium falciparum, P. falciparum |
Hungarian | P. falciparum, Plasmodium falciparum fertőzés |
Ontology: Plasmodium malariae infection (C0858319)
Concepts | Disease or Syndrome (T047) |
English | Plasmodium malariae infection, P.malariae |
Czech | P. malariae, Infekce způsobená Plasmodium malariae |
Dutch | P. malariae, Plasmodium malariae-infectie |
French | Infection à Plasmodium malariae, P.malariae |
German | P. malariae, Plasmodium malariae Infektion |
Hungarian | Plasmodium malariae fertőzés, P. malariae |
Italian | Plasmodium malariae, Infezione da Plasmodium malariae |
Japanese | 四日熱マラリア原虫, ヨッカネツマラリアゲンチュウカンセン, 四日熱マラリア原虫感染, ヨッカネツマラリアゲンチュウ |
Portuguese | P. malariae, Infecção por Plasmodium malariae |
Spanish | Infección por Plasmodium malariae, P malarie |
Ontology: Plasmodium ovale infection (C0858320)
Concepts | Disease or Syndrome (T047) |
English | Plasmodium ovale infection, p.ovale, p ovale, P.ovale, Plasmodium ovale; fever, fever; Plasmodium ovale |
Czech | P. ovale, Infekce způsobená Plasmodium ovale |
Dutch | Plasmodium ovale-infectie, P. ovale, Plasmodium ovale; koorts, koorts; Plasmodium ovale |
French | P.ovale, Infection à Plasmodium ovale |
German | Plasmodium ovale Infektion, P. ovale |
Hungarian | P. ovale, Plasmodium ovale fertőzés |
Italian | Plasmodium ovale, Infezione da Plasmodium ovale |
Japanese | 卵形マラリア原虫感染, ランケイマラリアゲンチュウカンセン, ランケイマラリアゲンチュウ, 卵形マラリア原虫 |
Portuguese | P. ovale, Infecção por Plasmodium ovale |
Spanish | Infección por Plasmodium ovale, P ovale |
Ontology: Plasmodium vivax infection (C0858321)
Concepts | Disease or Syndrome (T047) |
English | Plasmodium vivax infection, p.vivax, p vivax, P.vivax |
Czech | Infekce způsobená Plasmodium vivax, P. vivax |
Dutch | P. vivax, Plasmodium vivax-infectie |
French | Infection à Plasmodium vivax, P.vivax |
German | P. vivax, Plasmodium vivax Infektion |
Hungarian | Plasmodium vivax fertőzés, P. vivax |
Italian | Plasmodium vivax, Infezione da Plasmodium vivax |
Japanese | 三日熱マラリア原虫, ミッカネツマラリアゲンチュウ, 三日熱マラリア原虫感染, ミッカネツマラリアゲンチュウカンセン |
Portuguese | Infecção por Plasmodium vivax, P. vivax |
Spanish | Infección por Plasmodium vivax, P vivax |