Malarial Parasites

Genus Plasmodium

• 5 species infect man

- Plasmodium falciparum Monkey parasite-most common in man
Fatal
- Plasmodium vivax
- Plasmodium ovale
- Plasmodium malariae
- Plasmodium knowlesi

• Most important parasitic disease in man

 Genus Plasmodium

• Transmitted via mosquito bite

- Anopheles spp.:
(A. flavirostris)

• Amoeboid parasite
• Reproduces sexually and asexually
• Man is the intermediate host
Genus Plasmodium
• I.S sporozoite > salivary gland of mosquito
(bloodstream > liver > hepatocytes
•
• merozoites imerges to hepatocytes
• Sporozoites and schizonts : from liver
• Schizonts to merozoites – schiszogony in liver
• Exerythrocytic cycle (liver not in RBC)
• If erythrocytic cycle (will not infect liver)
• Sporozoite > merozoite will reinfect when from
liver
• Merozoite (fr liver) > hipnozoite
• Erythrocytic cycle:
release of merozoites from rbc infect new rbc

• Schizogony > release of new merozoites

 Genus Plasmodium

• During the exoerythrocytic cycle P.vivax and

P.ovale merozoites may reinfect liver cells and
turn into hypnozoites (dormant forms)
• Sporozoites turn into hypnozoites*

• malarial parasites feed on the hemoglobin

resulting in pigment production

• The erythrocytic cycle is periodic and

synchronous
 Genus Plasmodium

• Pathology / Clinical Manifestations:

- prodromal symptoms:
feeling of exhaustion
body aches
nausea
anorexia
vomiting
fever
- regular paroxysmal fever with
asymptomatic intervals (24 – 72hrs)
 Genus Plasmodium

• 3 stages of Malarial Paroxysm:

1. cold stage (15 – 60 mins)
2. hot stage (2 – 6 hours)
3. sweating stage (2 – 4 hours)

• The interval between attacks depend on the

length of the erythrocytic cycle / species

• Species that produce hypnozoites can cause

relapses
 Genus Plasmodium

• Infected red blood cells become less

deformable

• Knobs appear on the surface of infected rbcs

causing them to adhere to other cells and
platelets causing congestion of small capillaries
 Genus Plasmodium

• The parasite’s antigens act like bacterial LPS

and thus induces the production of TNF leading
to malarial fever

• Hemoglobin is digested forming hematin

(Toxic to cells bind resulting apoptosis)

• *apoptosis of endothelial cells

 Genus Plasmodium

• Complications:
- Cerebral Malaria- death
- Acute Renal Failure- dec blood and oxygenation of kidneys
- Hemolytic Anemia
- Blackwater Fever
- Dysenteric Malaria
- Algid Malaria- algor– circulatory system
- Pulmonary Edema
- Tropical Splenomegaly Syndrome
 Genus Plasmodium

• Diagnosis

- demonstration of the parasite in blood

smear (thick and thin smears)
- RDTs- Rapid dx test- detects Ag of P. falciparum infection
(HRP-2, aldolase, pLDH)
- QBC
- IHA
- IFAT
- ELISA
- PCR
 Plasmodium falciparum

• Malignant Tertian Malaria

• Asexual cycle: 48 hrs or less
• Infected cells are normal in size
• Multiple infection of rbcs are common
• Trophozoites demonstrate mostly ring forms
 Plasmodium falciparum

• Schizont demonstrate 8 – 24 merozoites

• Gametocytes are sometimes crescent- or
sausage shaped
• Maurer’s dots
 Plasmodium vivax

• Benign Tertian Malaria (48 hrs)- milder form

• Infected rbcs are larger than normal
• Trophozoites’ cytoplasm is more abundant and
amoeboid than P. falciparum: irregular and lively
• Schuffner’s dots are often present: infects retics
 Plasmodium vivax

• Schizonts have 12 – 24 merozoites

 Plasmodium ovale

• Benign Tertian Malaria

• Infected cells are larger than normal
• Often oval with irregular edge

• Schuffner’s dots are almost always present

• Schizonts usually have 8 merozoites arranged
around a of pigment
(rosette)
 Plasmodium ovale

• Gametocytes are not easily distinguished from

other species
 Plasmodium malariae

• Quartan Malaria (72 hrs)

• Infected cells are either normal sized or
smaller than normal
• Multiple infection of rbcs are rare

• Trophozoites may demonstrate band forms

 Plasmodium malariae

• Schizont may have 6 – 12 merozoites (8 – 10)

• Gametocytes are similar with P. vivax but

smaller
 Plasmodium knowlesi

• Originally identified as a primate malaria

• Quotidian Malaria (24 hr erythrocytic cycle)
• Morphologically closest to P. malariae
• Does not relapse
• Distinguished from P. malariae through
immunologic or molecular methods

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