II. Epidemiology

  1. Incidence
    1. Malaria is the 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. Europe and North America infections are typically due to travel
      1. European, North American traveler cases: 30,000/year
      2. U.S. Cases reported to CDC per year: 1500 to 2000 (out of 18 million U.S. travelers to Malaria endemic areas)
      3. Malaria was endemic to North America, but was eradicated in the mid-twentieth century
    4. Worldwide Infections: 300 million per year
      1. Children under age 5 years are disproportionally affected
      2. Worldwide Mortality: 500,000 deaths per year (some estimates have been as high as 1 to 3 Million per year)
        1. Malaria (esp. P. falciparum) 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
      3. Southeast Asia
    4. Low Risk
      1. Latin America

III. Pathophysiology

  1. See Vector-Borne Infection
  2. Transmitted by bite of female anopheline (or anopheles) Mosquito
    1. Usually bites between dusk and dawn
    2. Injects Malaria protozoa from Salivary Glands
    3. Other modes of human transmission (e.g. Blood Transfusion, congenital transmission) are rare
  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)
      3. Responsible for most Malaria deaths
    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. 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 (esp. P falciparum) requires emergent evaluation
    1. Clinical decompensation or death may occur within 24 to 36 hours in a Malaria naive patient

V. Symptoms

  1. Timing
    1. Presentation within the first month of return from travel to endemic region
      1. Plasmodium Falciparum Incubation Period is typically 12 to 14 days (range 7 to 30 days)
      2. See Fever in the Returning Traveler for timing of other illnesses in the differential
    2. Delayed presentation beyond 2 months may occur with the use of chemoprophylaxis
      1. Plasmodiun ovale and Plasmodium Vivax may have delayed presentations, months later
  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. Gastrointestinal Symptoms (may be isolated presentation in children)
      1. Nausea
      2. Vomiting
      3. Diarrhea
      4. 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. Meningismus

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 CSF Pleocytosis, mild increased CSF Protein)

IX. Diagnosis

  1. Peripheral Blood Smear
    1. Gold standard for diagnosis
    2. Stains
      1. Giemsa stain (reference 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. Thin stain can identify Malaria species and quantify Parasitemia
          3. 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. Thick stain evaluates for malaria Parasites in general
      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. Binax-NOW (only detect P. falciparum and P. vivax; only FDA approved test in U.S.)
      2. HRP-2 detection (only detects P. falciparum)
      3. LDH detection (detects all 4 Malaria types)
    2. Benefits
      1. Good Test Sensitivity and Negative Predictive Value, yet easy to perform and does not require lab facility
      2. Results available within 5 to 20 minutes
    3. Precautions
      1. All rapid tests should be followed by blood smears
        1. Positive tests do not quantitate Parasitemia
        2. Negative rapid tests should be confirmed with blood smears
      2. Decreased Test Sensitivity with low levels of Parasitemia
        1. Examples: Patients who took chemoprophylaxis, or prior exposure
  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: Falciparum or Knowlesi Malaria or Severe Case and Unknown Species

  1. See CDC emergency contact information as below for Malaria management guidance
  2. Precautions
    1. Substandard and counterfeit antimalarial use is widespread in resource limited and low income countries
    2. Anti-Malarials Considered safe in Pregnancy
      1. Chloroquine
      2. Hydroxychloroquine
      3. Quinine
      4. Clindamycin
      5. Mefloquin
      6. Artemisinin Combination Therapy (ACT) safe in second and third trimester
        1. Artemether/Lumefantrine (Coartem) may be used in first trimester if no other reasonable option
  3. Hospital Admission Criteria
    1. Admit Falciparum Malaria and Knowlesi cases to hospital (high mortality in first 48 hours)
      1. Also admit all undiferentiated cases where species of Malaria cannot be discerned
    2. High Risk Cohorts
      1. Immunocompromised
      2. Malaria naive patients (no prior Malaria infections)
      3. Children
      4. Pregnancy
    3. Severe case criteria (any of the following)
      1. Glasgow Coma Scale (GCS) <11 or Coma
      2. Seizures
      3. Severe Anemia (Hemoglobin <7 g/dl in adults, <5 g/dl in children age <12 years)
      4. Acute Kidney Injury
      5. Hypoglycemia
      6. Acute Respiratory Distress Syndrome
      7. Shock
      8. Disseminated Intravascular Coagulation
      9. Acidosis
      10. Liver Dysfunction
      11. Parasite Density >5%
  4. Artemisinin Combination Therapy (ACT) antiparasitic agents (2 agents)
    1. Regimens based on severity (see above for severe case criteria)
    2. General Protocol
      1. Agent 1: Artemisinin (or dihydroartemisinin, artemether, or Artesunate) - first-line agent
        1. See Artesunate (preferred in U.S.)
        2. Artemisinin is contraindicated in first trimester of pregnancy
        3. Use oral formulation in non-severe cases, and intravenous formulation in severe cases
      2. Agent 2: Lumefantrine (see below), Chloroquine, Sulfadoxine-pyrimethamine (Fansidar) or Mefloquine
      3. Treat for 3 days (6 days if travel to areas with high Malaria resistance)
    3. Non-Severe Cases: Artemether/Lumefantrine (Coartem)
      1. Each tablet contains 20 mg Artemether (an Artemisinin) and 120 mg Lumefantrine
        1. Tablets may be crushed and mixed with 10 ml water if unable to swallow tablets (e.g. children)
        2. Tablets are best absorbed with high fat foods
        3. Repeat dose if Vomiting occurs within 2 hours of dose
      2. Each dose based on weight
        1. Children 5 kg to 15 kg: 1 tablet per dose
        2. Children 15 kg to 25 kg: 2 tablets per dose
        3. Children 25 kg to 35 kg: 3 tablets per dose
        4. Children >35 kg and Adults: 4 tablets per dose
      3. Dosing (3 day course, with doses per weight as above)
        1. Give one dose every 8 hours for 2 doses on day 1, then one dose every 12 hours on days 2 and 3
    4. Severe Cases: Intravenous Artemisinin (Artesunate is preferred)
      1. Indicated in severe cases (see criteria above), including Parasite load >5%
      2. Start immediately at the time of diagnosis
      3. Artesunate 2.4 mg/kg at start, 12 and 24 hours, then daily until Parasitemia <1% (up to 7 days)
      4. Obtain blood smear Parasite stains for density every 12 hours
        1. May transition to a full course of oral therapy (see Coartem above) when Parasitemia <1%, at least 4 hours after third dose
  5. Other agents when Artemisinin Combination Therapy (ACT) is unavailable
    1. Chloroquine sensitive regions
      1. Chloroquine
        1. Adults
          1. Load: 1000 mg salt (600 mg base) orally at start
          2. Maintenance: 500 mg salt (300 mg base) orally at 6 hours, 24 hours and 48 hours after initial dose
        2. Child
          1. Load: 16.7 mg/kg salt (10 mg/kg base) orally at start
          2. Maintenance: 8.3 mg/kg salt (5 mg/kg base) orally at 6 hours, 24 hours and 48 hours after initial dose
      2. Hydroxychloroquine (Plaquenil)
        1. 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
        2. 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
    2. Chloroquine resistant regions
      1. Atovaquone/Proguanil (Malarone)
        1. See Atovaquone for dosing
      2. Quinine-based protocols (2 agents)
        1. General
          1. Avoid in severe disease
          2. Use 7 day course if acquired in Southeast Asia
        2. 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
        3. Second Agent
          1. Doxycycline 2.2 mg/kg up to 100 mg orally twice daily for 7 days (or Tetracycline) OR
          2. Clindamycin (if Tetracyclines contraindicated) 20 mg/kg orally for 3 to 7 days
      3. Mefloquine (other options are preferred)
        1. 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
        2. 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
  6. Plasmodium Malariae and Plasmodium knowlesi
    1. Artemisinin Combination Therapy (ACT) is recommended despite lack of Chloroquine resistance (see protocol below)
    2. Admit all Plasmodium knowlesi cases (high risk for severe disease)
  7. Following Initial Treatment: Plasmodium Ovale or Plasmodium Vivax (risk of relapsing infection)
    1. Risk of dormant Malaria (due to hypnozoites) and relapsing infection
      1. Follow initial course with following therapies to prevent relapsing infection
      2. Mothers infected with P. vivax or P. ovale during pregnancy
        1. Test infants for G6PD Deficiency after delivery
        2. Mothers should Breast feed and take either Primaquine (No G6PD Deficiency) or Chloroquine (G6PD deficient)
    2. No G6PD Deficiency
      1. Primaquine
        1. Adult: 52.6 mg salt (30 mg base) orally daily for 14 days after initial course
        2. Child: 0.8 mg/kg salt (0.5 mg/kg base up to 30 mg/day) orally daily for 14 days after initial course
        3. Decrease dose if Tinnitus or hyperexcitability occur
      2. Tafenoquine
        1. Adult (>age 16 years): 300 mg orally once after first or second day following Chloroquine course
        2. Contraindicated age <16 years or Psychotic Disorder
        3. Use only if Chloroquine or Hydroxychloroquine were used to treat initial infection
    3. G6PD Deficiency
      1. Continue Chloroquine prophylaxis 500 mg salt (300 mg base) dosed weekly for one year OR
      2. Primaquine may be considered if G6PD is mild or intermediate
        1. Consult infectious disease
  8. 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
  9. Other non-specific management
    1. Intravenous Fluids
    2. Antipyretics
    3. Antiemetics
  10. Follow-up
    1. Evaluate for Hemolytic Anemia at 30 days after treatment of severe cases

XI. Prevention

  1. See Prevention of Vector-borne Infection
  2. Malaria Chemoprophylaxis is critical and not taken adequately in as many as 75% of U.S. travelers
    1. See Malaria Chemoprophylaxis
  3. Malaria Vaccine
    1. WHO has recommended use for Malaria falciparum prevention in children
    2. Vaccination initiated in 2021 in Ghana, Malawi and Kenya (>1 million doses administered as of 2022)
    3. Alonso (2022) N Engl J Med 386(11): 1005-7 [PubMed]
  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 20 to 30% to skin every 3-4 hours or
    2. Picaridin 20% or
    3. p-Menthane-3,8-diol (PMD, Menthoglycol)
  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

XIII. Prognosis

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

XIV. Resources

  1. See Travel Resources
  2. CDC Malaria hotline (health care professionals)
    1. https://www.cdc.gov/parasites/contact.html
    2. Phone: 770-488-7788 (daytime, Monday to Friday, 9 am to 5 pm Eastern Standard Time)
    3. Phone: 855-856-4713 (daytime, toll free)
    4. Phone: 770-488-7100 (after hours, emergency operations center, ask to speak with DPDM expert)
  3. CDC Malaria Information
    1. http://www.cdc.gov/malaria
  4. Malaria Foundation International
    1. http://www.malaria.org

XV. 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. Nordurft-Froman and DeVos (2022) Crit Dec Emerg Med 36(4): 4-15
  5. Baird (1999) Med Clin North Am 83(4):923-44 [PubMed]
  6. Croft (2000) BMJ 321(7254):154-60 [PubMed]
  7. Feder (2013) Am Fam Physician 88(8): 524-30 [PubMed]
  8. Johnson (2012) Am Fam Physician 85(10): 973-7 [PubMed]
  9. Lo Re (2003) Am Fam Physician 68(3):509-16 [PubMed]
  10. Shahbodaghi (2022) Am Fam Physician 106(3): 270-8 [PubMed]

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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
Korean 상세불명의 말라리아
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
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
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
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
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
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
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