Malaria

DEFINITION Malaria is an infectious disease, which is

caused by protozoan parasites of genus plasmodium.

Causative Organism : Plasmodium falciparum Plasmodium vivax Plasmodium ovale Plasmodium malariae

The Symptoms of Malaria

Severe malaria• Seizures• Respiratory

distress• Anemia• Organ failure• Coma• Death

DIAGNOSIS Microscopic examination of blood Antigen detection test Patients history & clinical observation

TREATMENT  4-Aminoquinolines—

Chloroquine, Amodiaquine  Aryl-amino alcohols—

Quinine, Mefloquine, Halofantrine 8-Aminoquinolines—Primaquine Antifolate—

Sulfadoxine, Proguanil, Pyrimethamine Antibiotics—Tetracycline Qinghaosu—Artemisinin (derived from

leeches) New drugs—

Atovaquona, Pyronaridine, Benflumetol

PREVENTION Mosquito nets Keep your surroundings clean Mosquito repellants Vaccines for malaria are underdevelopment

PREVENTION IS BETTER THAN CURE

Case Study

PATIENTS PERFORMA

Name – Mr. X Age – 26 yrs Gender – Male Date of admission – 06/10/12 Date of discharge – 10/10/12

Chief complaintsC/O fever, vomiting, back pain, fatigue,

head ache X 3days.History of present illnessH/O back pain ,headache.Past Medical HistoryN/K/C/O DM, HTN, BA, Personal HistoryNon-alcoholic, Non-smoker.

Physical Examination Patient is conscious oriented Temp- 104 F Pulse- 90/min Bp- 130/90 mm/Hg RR- 20beats/minSystemic examinationCVS- S1S2+ CNS- NFNDRS- NVBS P/A- Soft

LAB INVESTIGATIONData's Observed Value Normal Value

Hb 12.6 gm/dl(↓) 14-18

RBC 4.4million/cubic mm(↓)

4.2-5.6

ESR(1 Hour) 25mm/hr(↑) 15-20

Platelet 110cubic mm (↓) 140-450

Pot 3.1meq/l (↓) 3.5-5.5

Bili (T) 1.8 mg/dl(↑) 0.2-1.4

Bili (D) 1.5mg/dl (↑) 0.0-0.4

Bili (ID) 0.3mm/dl Total-Direct

OTHER TEST’S Dengue test – Negative Polymerase chain reaction – Positive MP QBC – Positive (P.vivax)DiagnosisMalaria

DRUG CHARTDrugs Dose R.O.A Frequenc

yDuration

IV Fluids 2 Days

Cap. Doxycyclin

e

100mg P/O BD X 5 Days

Tab. Dolo 650mg P/O TDS X 1 Day

Tab. Larigo 600mg P/O OD X 5 Days

Inj. Emeset 4 mg I.V STAT X 2 Days

DRUG INTERACTIONS Doxycycline decrease the effect of

amoxicilline by pharmacodynamic antagonism- Use alternatively

Discharge Advice:Tab. Larigo (600mg) OD for 14 daysTab. Dolo (650mg) STATCap. Doxycycline (100mg) BD for 7 DaysReview after 14 Days

PATIENTS COUNSELLING Take adequate rest

Drink plenty of clean water.

MB QBC Test recommended after 14 days