Malaria

Aka: Malaria, Plasmodium Falciparum, Plasmodium Malariae, Plasmodium Vivax, Plasmodium Ovale, Plasmodium Falciparum Infection, Plasmodium Malariae Infection, Plasmodium Vivax Infection, Plasmodium Ovale Infection, Ovale Malaria, Falciparum Malaria, Vivax Malaria, Quartan Malaria, Tertian Fever, Quartan Fever

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II. Etiology: Malaria Species

  1. Plasmodium Vivax
  2. Plasmodium Ovale
  3. Plasmodium Falciparum
  4. Plasmodium Malariae (Quartan Malaria)

III. Pathophysiology

  1. See Vector-Borne Infection
  2. Transmitted by bite of anopheline (or anopheles) Mosquito
    1. Usually bites between dusk and dawn
    2. Injects Malaria protozoa from Salivary Glands
  3. Species of Malaria
    1. Plasmodium Falciparum (most common and most life threatening)
      1. Fulminant Malaria associated with high Parasitemia and intravascular congestion
      2. Incubation period: Typically 12-14 days (ranges from 7 to 30 days)
    2. Plasmodium Vivax
      1. Incubation period: Months to years
    3. Plasmodium Malariae (Quartan Malaria)
      1. Fever recurs every 3 days (Quartan Fever), instead of the 2 day intervals of other Plasmodium
    4. Plasmodium Ovale
      1. Incubation period: Months to years
    5. Plasmodium knowlesi
      1. Emerging pathogen in those exposed to macque monkeys
      2. Similar in appearance to p. Malariae
  4. Life cycle of Malaria
    1. Injected from Mosquito as sporozoite
    2. Sporozoites invade hepatocytes in human liver
      1. Develop into merozoites after weeks to months of development within hepatocytes
      2. Merozoites released into blood stream
      3. Sporozoites may lie dormant in liver (hypnozoites)
        1. Occurs with Plasmodium Vivax and Plasmodium Ovale
        2. Symptoms recur when reactivates in months to years
    3. Merozoites invade erythrocytes and circulate freely
      1. P. Malariae may remain in Red Blood Cells without lysis, latent for months to years
      2. Typically results in Red Blood Cell lysis within 48-72 hours of erythrocyte invasion
      3. Hemolysis is associated with fever spikes
        1. Fever spikes typically occur randomly, but may occur with RBC lysis in a pattern
        2. May cause Tertian Fever (recurring every third day)
        3. May cause Quartan Fever (recurring every fourth day)
    4. Circulating merozoites differentiate into Gametocytes
      1. Gametocytes are the sexual form of plasmodium
      2. Mosquito ingests gametocytes from infected host
      3. Protozoa develop within the Mosquito over a 10-21 day course
      4. Mosquito infects next human host with bite

IV. Epidemiology

  1. Incidence
    1. Most common life threatening disease for travelers
    2. Mosquito population is expected to as much as double with global warming (0.4 C) by 2020
    3. European, North American traveler cases: 30,000/year
    4. Cases reported to CDC per year: 1500 (out of 18 million U.S. travelers to Malaria endemic areas)
    5. Worldwide Infections: 300 million per year
    6. Worldwide Mortality: 1-3 million deaths per year
      1. Malaria is among the top three infectious causes of death in the world
      2. Other high mortality infectious causes include HIV Infection and Tuberculosis)
  2. Timing
    1. Majority of Malaria outbreaks occur between May and December
    2. Highest risk is during and after the rainy season
      1. River beds and stagnant pools of water are most common breading grounds
  3. Regions
    1. Endemic to tropical and subtropical world around the equator (106 countries as of 2010)
    2. Highest Risk
      1. Sub-Saharan Africa
      2. Papua New Guinea
      3. Solomon Islands
      4. Vanuatu
    3. Intermediate Risk
      1. Haiti
      2. Indian subcontinent
    4. Low Risk
      1. Southeast Asia
      2. Latin America

V. Symptoms

  1. Timing
    1. Presentation within the first month of return from travel to endemic region
    2. Delayed presentation beyond 2 months may occur with the use of chemoprophylaxis
  2. Initial prodrome
    1. Headache
    2. Malaise
  3. Next
    1. Fever (>50% of patients)
    2. Shaking chills
  4. Next
    1. Drowsiness
    2. Lethargy
    3. Fatigue
  5. Other symptoms
    1. Myalgias
      1. More severe in Dengue Fever
    2. Muscle tenderness
      1. More severe in Leptospirosis and Typhus
    3. Arthralgias
    4. Back pain
    5. Nausea
    6. Vomiting
    7. Diarrhea
    8. Abdominal Pain

VI. Signs

  1. Fever for 1-8 hours
  2. Fever recurs
    1. Plasmodium Vivax: 48 hour intervals (Tertian Fever)
    2. Plasmodium Malariae: 72 hour intervals (Quartan Fever)
    3. Plasmodium Falciparum: Variable
  3. Gastrointestinal findings (in <35-40% of cases)
    1. Tender Splenomegaly
  4. Severe Falciparum Malaria
    1. Hypotension and shock
    2. Multisystem failure
      1. Pulmonary edema
      2. Acute Respiratory Distress Syndrome
      3. Renal Failure (1% of cases)
      4. Jaundice and liver failure (associated with poor prognosis)
    3. Cerebral Malaria
      1. Altered Mental Status to unresponsive
      2. Seizures
      3. Meningism

VII. Differential Diagnosis

  1. See Fever in the Returning Traveler
  2. See Vector-Borne Infection
  3. Other Arboviruses that are Vector-Borne Infections (Aedes aegypti Mosquito-Borne Disease)
    1. Typhoid Fever
    2. Dengue Fever
    3. Chikungunya
    4. Zika Virus
    5. Yellow Fever
  4. Other causes in the differential diagnosis of Malaria
    1. Viral Hepatitis
    2. Acute HIV Infection
  5. Rash is uncommon in Malaria (aside from Petechiae in severe Falciparum Malaria with DIC) and suggests other diagnosis
    1. See Febrile Traveler with Rash
    2. Dengue Fever
    3. Chikungunya
    4. Zika Virus
    5. Typhus
    6. Enteric Fever
    7. Meningococcus

VIII. Labs

  1. Blood Glucose
    1. Hypoglycemia may occur (esp. children)
  2. Complete Blood Count (CBC) with differential
    1. Especially consider Malaria with Leukopenia and Left Shift, Thrombocytopenia
    2. Hemoglobin or Hematocrit consistent with Anemia (29%)
    3. Leukopenia with White Blood Cell Count <5000/mm3 (26%)
    4. Thrombocytopenia (45%)
    5. Bandemia (85%)
  3. Urinalysis
    1. Urobilinogen positive
    2. Hemoglobinuria (rare, may occur with Plasmodium Falciparum)
  4. Cerebrospinal Fluid Examination
    1. Indicated in Altered Mental Status and fever
    2. Exclude Meningitis and Encephalitis (esp. if Malaria diagnosis is unclear)
    3. Malaria CSF is typically normal (aside from mild Pleocytosis, mild increased protein)

IX. Diagnosis

  1. Peripheral Blood Smear
    1. Gold standard for diagnosis
    2. Stains
      1. Giemsa stain (standard stain for Malaria evaluation with thick and thin smears)
        1. Thin blood smear (first-line Malaria evaluation)
          1. Giemsa stain of blood fixed with Alcohol to prevent Red Blood Cell lysis
          2. High Test Sensitivity
        2. Thick blood smear (perform if thin blood smear negative)
          1. Giemsa stain of blood allowed to dry on slide (allowing cell lysis)
      2. Wright stain (standard stain for most Complete Blood Count associated manual differentials)
        1. Test Sensitivity approaches that of Giemsa stain
    3. Protocol
      1. Stat blood smear with direct communication with reading pathologist (alert for Malaria concern)
      2. Examine new smear every 12-24 hours for 2-3 days (low Parasitemia may require additional smears)
      3. Sample is best obtained when patient is febrile
    4. Image
      1. HemeoncFalciparum.jpg
  2. Rapid blood dipstick testing (when smear not available)
    1. Tests
      1. HRP-2 detection (only detects P. falciparum)
      2. LDH detection (detects all 4 Malaria types)
    2. Precautions
      1. Decreased Test Sensitivity with low levels of Parasitemia
        1. Examples: Patients who took chemoprophylaxis, or prior exposure
      2. Negative rapid tests should be confirmed with blood smears
  3. Malaria PCR
    1. Detects low levels of parsites in blood (<5 Parasites/ul)
    2. Distinguishes between plasmodium species
    3. May be used to monitor response to treatment at 5-8 days (however False Positives may occur)

X. Management: Chemoprophylaxis

  1. See Malaria Chemoprophylaxis

XI. Precautions

  1. Fever in a returning traveler from Malaria endemic area is Malaria until proven otherwise
  2. Up to 50% of Malaria cases are misdiagnosed on the first visit
  3. Initial presentations are often mild and non-specific (fever, chills, malaise, myalgia, Headache)
  4. Malaria is an emergent evaluation

XII. Management: Non-Falciparum Malaria treatment

  1. Uncomplicated non-Falciparum Malaria
    1. Step 1: Chloroquine
      1. Dose: 600 mg load, then 300 mg in 6-8 hours, then 300 mg daily for 2 days
      2. Obtain baseline EKG for QT Prolongation and monitor as needed
    2. Step 2: Primaquine (if G6PD Deficiency negative)
      1. Used to eliminate hypnozoites (liver stage) of vivax and ovale species
      2. Dose: 30 mg daily for 2 weeks after Chloroquine course
      3. Decrease dose if Tinnitus or hyperexcitability occur
      4. Use Chloroquine weekly for 6 months if patient G6PD Deficiency positive
  2. Severe Non-Falciparum Malaria
    1. Replace Chloroquine with Quinine, Quinidine or Artesunate
    2. Follow course with Primaquine if without G6PD Deficiency (as above)

XIII. Management: Falciparum Malaria treatment

  1. Admit all cases to hospital (high mortality in first 48 hours)
    1. Also admit all undiferentiated cases where species of Malaria cannot be discerned
  2. Combination antiparasitic agents (2 agents)
    1. Intravenous antimalarial agents for severe disease or Parasite load >5%
    2. Agent 1: IV Artemisinin (or dihydroartemisinin, artemether, or artesunate) - first-line agent
      1. May use Lumefantrine/artemether twice daily for 3 days in less severe cases
    3. Agent 2: Chloroquine, Sulfadoxine-pyrimethamine (Fansidar) or Mefloquine
    4. Treat for 3 days (6 days if travel to areas with high Malaria resistance)
  3. Specific complication management
    1. Shock
      1. Intravenous hydration (including fluid boluses)
      2. Obtain Blood Cultures and add third generation Cephalosporin to regimen
        1. Continue until cultures back (risk of comorbid Bacterial Sepsis)
    2. Cerebral Malaria (18% of cases)
      1. Seizures
      2. Supportive care including intubation may be needed
      3. Meningism (uncommon but carries 23% mortality)
    3. Bleeding
      1. Coagulopathy reversal
      2. Blood Transfusion

XIV. Prevention

  1. See Malaria Chemoprophylaxis
    1. Critical and not taken adequately in as much as 75% of U.S. travelers
  2. See Prevention of Vector-borne Infection
  3. Malaria Vaccine (investigational in 2012)
  4. Stay in air conditioned or well screened rooms
  5. Reduce nighttime outdoor activity (Dusk until dawn)
  6. Apply an effective Insect repellent
    1. DEET 30% to skin every 3-4 hours or
    2. p-Menthane-3,8-diol (PMD)
  7. Spray clothing and bed nets with Permethrin
  8. Wear long sleeve shirt and pants
  9. Use Insecticide aerosols at dusk in living areas
  10. Use a strong fan at bedside
  11. Use Mosquito bed netting even in hotel rooms
    1. Mosquito net pre-treated with Permethrin
    2. Reapply Permethrin every 6 months

XV. Complications

  1. Encephalopathy
  2. Hypoglycemia
  3. Acute Renal Failure
  4. Hepatic Dysfunction
  5. Pulmonary Edema
  6. Disseminated Intravascular Coagulation
  7. Hemolytic Anemia

XVI. Prognosis

  1. Plasmodium Falciparum Mortality: 4% (20% severe cases)
  2. More severe cases in pregnant women and children

XVII. Resources

  1. See Travel Resources
  2. CDC Malaria hotline (physicians)
    1. Phone: 855-856-4713 (daytime)
    2. Phone: 770-488-7100 (after hours, emergency operations center)
  3. CDC Malaria
    1. http://www.cdc.gov/malaria
  4. Malaria Foundation International
    1. http://www.malaria.org

XVIII. References

  1. Anderson (2014) Crit Dec Emerg Med 28(7): 11-9
  2. Black, Martin, DeVos (2018) Crit Dec Emerg Med 32(8): 3-12
  3. Mason and Marsh in Herbert (2019) EM:Rap 19(5):12-3
  4. Baird (1999) Med Clin North Am 83(4):923-44 [PubMed]
  5. Croft (2000) BMJ 321(7254):154-60 [PubMed]
  6. Feder (2013) Am Fam Physician 88(8): 524-30 [PubMed]
  7. Johnson (2012) Am Fam Physician 85(10): 973-7 [PubMed]
  8. Lo Re (2003) Am Fam Physician 68(3):509-16 [PubMed]

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Related Studies

Ontology: Malaria (C0024530)

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

  • See your doctor for medicines that protect you
  • Wear insect repellent with DEET
  • Cover up
  • Sleep under mosquito netting

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, ﾏﾗﾘｱｹﾞﾝﾁｭｳｶﾝｾﾝ, 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
Derived from the NIH UMLS (Unified Medical Language System)

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]
Derived from the NIH UMLS (Unified Medical Language System)

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
Derived from the NIH UMLS (Unified Medical Language System)

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
Derived from the NIH UMLS (Unified Medical Language System)

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
Derived from the NIH UMLS (Unified Medical Language System)

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
Derived from the NIH UMLS (Unified Medical Language System)

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
Derived from the NIH UMLS (Unified Medical Language System)

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
Derived from the NIH UMLS (Unified Medical Language System)

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
Derived from the NIH UMLS (Unified Medical Language System)

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)
Derived from the NIH UMLS (Unified Medical Language System)

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
Derived from the NIH UMLS (Unified Medical Language System)

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ｹﾞﾝﾁｭｳｶﾝｾﾝ, ﾈｯﾀｲﾈﾂﾏﾗﾘｱｹﾞﾝﾁｭｳ
Czech Infekce způsobená Plasmodium falciparum, P. falciparum
Hungarian P. falciparum, Plasmodium falciparum fertőzés
Derived from the NIH UMLS (Unified Medical Language System)

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ｹﾞﾝﾁｭｳｶﾝｾﾝ, 四日熱マラリア原虫感染, ﾖｯｶﾈﾂﾏﾗﾘｱｹﾞﾝﾁｭｳ
Portuguese P. malariae, Infecção por Plasmodium malariae
Spanish Infección por Plasmodium malariae, P malarie
Derived from the NIH UMLS (Unified Medical Language System)

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, ﾗﾝｹｲﾏﾗﾘｱｹﾞﾝﾁｭｳｶﾝｾﾝ, ﾗﾝｹｲﾏﾗﾘｱｹﾞﾝﾁｭｳ, 卵形マラリア原虫
Portuguese P. ovale, Infecção por Plasmodium ovale
Spanish Infección por Plasmodium ovale, P ovale
Derived from the NIH UMLS (Unified Medical Language System)

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ｹﾞﾝﾁｭｳ, 三日熱マラリア原虫感染, ﾐｯｶﾈﾂﾏﾗﾘｱｹﾞﾝﾁｭｳｶﾝｾﾝ
Portuguese Infecção por Plasmodium vivax, P. vivax
Spanish Infección por Plasmodium vivax, P vivax
Derived from the NIH UMLS (Unified Medical Language System)

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