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TM: Vector borne diseases - Malaria lifecycle + epidemiology (i) (Mosquito…

- - - - most severe + widespread
      - sometimes fatal
      - vessel occlusion by schizonts
        
        renal failure
        
        cerebral malaria
        
        shock
        
        lactic acidosis
        
        usually reversible dysfunction when txed
    - - recurrence of disease due to persistence of blood forms in small nos between attacks
      - caused by inadequate tx + resistance
    - - infected RBCs normal in size + shape
      - no stippling except Maurers dots/clefts (membranous)
      - small ring trophozoites - often count chromatin dots + accole forms (parasitises marginal portion of RBC)
      - NB multiple infection of RBCs common
      - schizont produces up to 32 merozoites + is not normally found in peripheral blood
      - crescent shaped gametocyte
      - may cause high levels of infection
  - - - less acute
      - rarely fatal
    - - schuffner's dots (haematological finding) in all RBCs during stippling stages
      - infected RBCs increase in size
      - larger trophozoites
      - occasionally multiple infection of RBCs
      - large schizont (fills entire RBC)
        
        produces rosette of 12-24 merozoites with central pigment in middle
      - large oval/round gametocyte, fills RBC
  - - - schuffner's dots (haematological finding) during stippling stages
      - infected RBC increases in size (by up to 30%), + is oval with fimbriated edges
      - trophozoites are small + compact + have a small amount of pigment
      - multiple infection of RBCs v occasionally
      - schizont produces 8-12 merozoites
      - round/oval gametocyte (smaller than P vivax)
  - - - infected RBCs often smaller than normal
      - no stippling
      - compact trophozoite stains densely (band form common)
      - multiple infection of RBCs rare
      - schizont produces rosette of 6-12 merozoites with pigment
      - small round coarse gametocyte with dark pigment