[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Conditions](https://durgical.com/en/conditions/) › Malaria [Conditions](https://durgical.com/en/conditions/) · [Systemic conditions](https://durgical.com/en/conditions/) # Malaria Malaria is a parasitic infection spread by Anopheles mosquito bites that causes cycles of fever and destroys red blood cells; one type can quickly turn deadly. Updated 2026-10-30 ## Structures involved Tap one to see what it is and open it in 3D. - [Spleen](https://durgical.com/en/anatomy/spleen/) - [Liver](https://durgical.com/en/anatomy/liver/) - [Kidneys](https://durgical.com/en/anatomy/kidney/) - [White matter](https://durgical.com/en/anatomy/white-matter-of-telencephalon/) - [Retina](https://durgical.com/en/anatomy/retina/) ## In biochemistry - [Glucose-6-phosphate dehydrogenase (G6PD)](https://durgical.com/en/biochemistry/enzymes/glucose-6-phosphate-dehydrogenase/) - [Hemoglobin variants (HbA, HbA2, HbF, HbS, HbC)](https://durgical.com/en/biochemistry/topics/hemoglobin-variants/) ## Microorganisms that cause it - [Anopheles](https://durgical.com/en/microbiology/anopheles/) - [Plasmodium vivax](https://durgical.com/en/microbiology/plasmodium-vivax/) - [Plasmodium falciparum](https://durgical.com/en/microbiology/plasmodium-falciparum/) - [Plasmodium malariae and Plasmodium ovale](https://durgical.com/en/microbiology/plasmodium-malariae-and-plasmodium-ovale/) ## In immunology - [Spleen: white pulp, red pulp, asplenia](https://durgical.com/en/immunology/spleen-white-pulp-red-pulp-asplenia/) - [Immunity to microbes: which arm defends against what](https://durgical.com/en/immunology/immunity-to-microbes-which-arm-defends-against-what/) ## In the clinical exam - [Body temperature and fever patterns](https://durgical.com/en/clinical-exam/body-temperature-and-fever-patterns/) - [Fever, infection and sepsis: the bedside signs](https://durgical.com/en/clinical-exam/fever-infection-and-sepsis-the-bedside-signs/) ## In physiology - [The red cell life cycle and the spleen](https://durgical.com/en/physiology/the-red-cell-life-cycle-and-the-spleen/) - [Fever](https://durgical.com/en/physiology/fever/) ## Why it happens - [Systemic effects of inflammation: fever, acute-phase proteins, leukocytosis, sepsis](https://durgical.com/en/general-pathology/systemic-effects-of-inflammation-fever-acute-phase-proteins-leukocytosis-sepsis/) - [Health effects of climate change](https://durgical.com/en/general-pathology/health-effects-of-climate-change/) - [Anemia physiology and compensation](https://durgical.com/en/physiology/anemia-physiology-and-compensation/) - [Blood cells on a smear: erythrocytes, leukocytes, platelets](https://durgical.com/en/histology/blood-cells-on-a-smear-erythrocytes-leukocytes-platelets/) ## What it is A parasitic infection by Plasmodium species, spread by the bite of infected female Anopheles mosquitoes, that causes cyclic fever and destroys red blood cells; P. falciparum can quickly become life-threatening. ## Who gets it Endemic in tropical regions. In Colombia transmission is mainly in lowland rural areas such as the Pacific coast and the Amazon; P. vivax and P. falciparum are the main species, and their share varies by area. In 2016 Colombia reported 83,356 cases, 57% due to P. falciparum and 39.7% to P. vivax (preliminary figures from non-WHO sources). ## Causes - Plasmodium falciparum, P. vivax, P. malariae, P. ovale and P. knowlesi - Bite of an infected female Anopheles mosquito - Less often: blood transfusion, shared needles or mother-to-child (congenital) transmission ## Risk factors - Living in or travelling to endemic areas, especially rural lowlands - Outdoor work at dusk and night (mining, farming, logging) - No prior immunity: young children, travellers, pregnant women - Not using bed nets, repellents or chemoprophylaxis when indicated - Pregnancy and HIV infection (more severe disease) ## Pathophysiology Sporozoites infect the liver, then merozoites invade red cells and multiply; synchronous rupture of red cells causes the fever paroxysms and hemolysis. P. falciparum-infected cells stick to small-vessel walls (sequestration), impairing flow to brain, kidney and other organs. P. vivax and P. ovale can stay dormant in the liver (hypnozoites) and relapse. ## Classification - Uncomplicated malaria - Severe (complicated) malaria - By species: falciparum, vivax, malariae, ovale, knowlesi - Malaria in pregnancy and congenital malaria ## Symptoms and signs - Fever with chills and sweats, sometimes in cycles - Headache, muscle aches and malaise - Nausea, vomiting or diarrhea - Pallor and fatigue from anemia - Enlarged [spleen](https://durgical.com/en/anatomy/spleen/) and liver - Mild jaundice ## Red flags - Confusion, drowsiness, seizures or coma (cerebral malaria) - Breathing difficulty or pulmonary edema - Severe anemia or bleeding - Low blood sugar, acidosis or shock - Dark urine or little urine (hemoglobinuria, kidney injury) - High parasite density on the smear, or inability to keep fluids down ## Diagnosis **Clinical** Fever in anyone who lives in or has visited an endemic area is treated as possible malaria until tested; clinicians look for signs of severe disease. **Tests** Thick blood smear detects and counts parasites; thin smear identifies the species. Rapid antigen tests help where microscopy is not available. Blood count, glucose, [kidney](https://durgical.com/en/anatomy/kidney/) and [liver](https://durgical.com/en/anatomy/liver/) tests, and lactate assess severity. **Imaging** Not needed to diagnose; [chest](https://durgical.com/en/anatomy/region/chest/) X-ray or brain imaging only when complications are suspected. ## Differential diagnosis - Dengue - Typhoid fever - Leptospirosis - Viral hepatitis - Bacterial sepsis - Meningitis or encephalitis ## Goal of treatment Clear the parasite quickly, prevent progression to severe disease and death, eliminate dormant liver forms in vivax and ovale malaria, and reduce transmission. ## Treatment **Medical** Uncomplicated malaria: oral antimalarials chosen by species and local guidelines, such as artemisinin-based combination therapy for falciparum and chloroquine where vivax remains sensitive. **Medical** Vivax and ovale: an 8-aminoquinoline (primaquine or tafenoquine) to clear liver hypnozoites, after G6PD testing. **Acute** Severe malaria: hospital care with intravenous artesunate, management of glucose, fluids, anemia (transfusion), seizures and kidney failure. **Follow-up** Repeat smears to confirm parasite clearance and follow-up for relapse. ## Drugs for this condition - [Doxycycline](https://durgical.com/en/pharmacology/doxycycline/) - [Hydroxychloroquine](https://durgical.com/en/pharmacology/hydroxychloroquine/) ## Complications - Cerebral malaria - Severe anemia - Acute kidney injury - Acute respiratory distress syndrome - Hypoglycemia and metabolic acidosis - Splenic rupture - Low birth weight, miscarriage or stillbirth in pregnancy ## Prognosis Uncomplicated malaria treated early usually resolves fully. Severe falciparum malaria carries a substantial risk of death even with treatment; vivax can relapse months later without radical cure. ## Prevention - Insecticide-treated bed nets and indoor residual spraying - Repellents and protective clothing - Chemoprophylaxis for travellers, according to the destination - Early diagnosis and treatment to cut transmission ## Test yourself Think of the answer, then tap the question to see it. ## Which Plasmodium species causes most severe malaria and why? P. falciparum: infected red cells stick to small-vessel walls (sequestration), it reaches high parasite densities and it invades red cells of all ages. ## What is the difference between the thick and the thin blood smear? The thick smear concentrates blood to detect parasites and count them; the thin smear shows parasite morphology to identify the species. ## Why do P. vivax and P. ovale relapse and how is this prevented? They leave dormant liver forms (hypnozoites). An 8-aminoquinoline clears them; G6PD deficiency must be ruled out first because of hemolysis risk. ## Which features define severe malaria? Impaired consciousness or seizures, severe anemia, hypoglycemia, acidosis, kidney injury, pulmonary edema, shock, bleeding, jaundice or high parasitemia (criteria vary slightly). [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/conditions/malaria/) ## Related conditions - [Dengue](https://durgical.com/en/conditions/dengue/) - [Leptospirosis](https://durgical.com/en/conditions/leptospirosis/) - [Viral hepatitis](https://durgical.com/en/conditions/viral-hepatitis/) - [Splenic injury](https://durgical.com/en/conditions/splenic-injury/) - [Chikungunya](https://durgical.com/en/conditions/chikungunya/) - [Leishmaniasis](https://durgical.com/en/conditions/leishmaniasis/) Educational information, not medical advice. For any symptom, see a health professional. Sources: [Malaria](https://www.ncbi.nlm.nih.gov/books/NBK551711/) (StatPearls (NCBI Bookshelf), 2023); [Malaria in Brazil, Colombia, Peru and Venezuela: current challenges in malaria control and elimination](https://europepmc.org/article/PMC/PMC5496604) (Malaria journal, 2017) · adapted, [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/). [← All conditions](https://durgical.com/en/conditions/) ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/conditions/malaria/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/malaria/