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Cerebral Malaria Pathogenesis Explained

This document summarizes the pathogenesis of malaria. It begins by introducing malaria as a major infectious disease that kills over 1 million people per year, most of them young children in Africa. It then describes the life cycle of the Plasmodium parasites that cause malaria, including the hepatic and erythrocytic phases. Key aspects of pathogenesis include the adhesion protein PfEMP1 that causes infected red blood cells to stick in blood vessels and can lead to cerebral and placental malaria. The clinical picture is also summarized, from initial prodromal symptoms to anemia, splenomegaly, hepatomegaly, and multi-organ involvement due to parasite sequestration in tissues. Secondary infections and high fever are also discussed

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Kareem Waleed Ibrahim Hamimy
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99 views20 pages

Cerebral Malaria Pathogenesis Explained

This document summarizes the pathogenesis of malaria. It begins by introducing malaria as a major infectious disease that kills over 1 million people per year, most of them young children in Africa. It then describes the life cycle of the Plasmodium parasites that cause malaria, including the hepatic and erythrocytic phases. Key aspects of pathogenesis include the adhesion protein PfEMP1 that causes infected red blood cells to stick in blood vessels and can lead to cerebral and placental malaria. The clinical picture is also summarized, from initial prodromal symptoms to anemia, splenomegaly, hepatomegaly, and multi-organ involvement due to parasite sequestration in tissues. Secondary infections and high fever are also discussed

Uploaded by

Kareem Waleed Ibrahim Hamimy
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

Malarial Pathogenesis

By: Kareem Waleed Hamimy


6th Year Medical Student
Kasr Al Ainy - Cairo University
A short introduction
 Malaria
Why?
What?
How?
Who?
Where?
 Pathogenesis
 Clinical picture
Why Malaria ?
 One of the most common infectious
diseases & an enormous public-health
problem.
 Each year, it causes disease in
approximately 650 million people & kills
1-3 million, most of them young children
in Africa.
 At least one death every 30 seconds.
What is Malaria ?
 Malaria is a vector-borne infectious
disease caused by protozoan parasites
of the genus plasmodium.
 The most serious forms of the disease
are caused by Plasmodium falciparum
and Plasmodium vivax.
How?
Who?
 Malaria is a disease which
can be transmitted to
people of all ages, bitten
by a vector
 Young children and
pregnant women in high
transmission areas are at
a large risk.
Where?
Malarial Pathogenesis
 Hepatic phase
Sporozoites infect hepatocytes, multiplying
asexually & asymptomatically for a period of
6–15 days.
Then they differentiate into merozoites 
rupture the hepatocytes  escape to blood
stream undetected (wrapping itself in the cell
membrane of the infected host liver cell).
Malarial Pathogenesis
 Erythrocytic phase
Within the red blood cells the parasites
multiply further, again asexually, periodically
breaking out of their hosts to invade fresh
red blood cells.
 p.vivax and p.ovale
 do not immediately develop into merozoites
They develop first to Hypnozoites (dormant
form) for 6-12 month leading to long
incubation and late relapses
Malarial Pathogenesis
 PfEMP1
Plasmodium falciparum erythrocyte membrane
protein 1
Adhesion (protective) protein produced by
p.falciparum expressed on surface of RBCs
causing it to stick to the walls slowing its lysis in
spleen.
Block endothelial venules cerebral &
placental malaria.
Extreme diversity  not a good immune
targets.
Pathogenesis of clinical picture
 Prodromal symptoms (influenza like)
Hepatic phase where the parasite asexually
and asymtomatically multiply.
 Malarial paroxysms
Decreased osmotic fragility  rupture of
RBCs
Release of metabolites & toxins
Release of cytokines such as TNF and
interleukin-1 from macrophages, resulting in
chills and high grade fever.
Pathogenesis of clinical picture
 Anemia
Febrile paroxysmal hemolysis
Immune & Non Immune hemolysis
Increased splenic clearance
Dyserythropoeisis in BM
Drug induced hemolysis
 Bone marrow
Iron sequestration  Dyserythropoeisis
Dysthrombopoeisis
Pathogenesis of clinical picture
 Spleen
Splenomegaly
○ Edema of the pulp
○ RES hyperplasia
○ Increased phagocytic function
○ New guinea “Tropical splenomegaly syndrome”
 Liver
Hepatomegaly (hepatic phase)
Malarial pigments  greyish black
Falciparum  malarial hepatitis
Pathogenesis of clinical picture
 Due to adherence factor of falciparum
 blocking of venules of organs lead to
a lot of manifestations as
Cerebral malaria (severe headache,
drowsiness, confusion, coma)
 Placental malaria (premature delivery,
intrauterine growth retardation iURD)
Dysenteric malaria (abdominal pain,
vomiting, GIT bleeding )
Pathogenesis of clinical picture
 CVS
Anemia leads to
○ Hypotension
○ Tachycardia
○ Muffled heart sounds
 Kidney
Immune complexes  Nephrotic syndrome
○ Albuminuria
○ Edema
○ hypertension
Malarial
Infections

High
Secondary Clinical Grade
Infection
Picture Fever

Anti
Malarial
Drugs
Any Questions ?
THANK YOU

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