Plasmodium is a topic covered in the Johns Hopkins Antibiotic (ABX) Guide.

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MICROBIOLOGY

  • Malaria is caused by Plasmodium parasites belonging to the Apicomplexa group of protozoa, transmitted by night-time or pre-dawn biting female Anopheles sp. mosquitoes.
  • CDC reported 1,727 U.S. cases in 2013, a 2% increase from 2012. [8]
    • P. falciparum (61% of U.S. cases)
      • Invades RBCs of all ages
      • Causes most severe and lethal illness
        • RBCs rosette and sequester in microvasculature and damage heart, brain, kidney, lung, placenta.
    • P. vivax [11]
      • Most common type outside of sub-Saharan Africa
      • Preferentially invades reticulocytes and requires Duffy antigen for RBC entry
      • Can persist in hepatocytes as hypnozoites for months to years
      • Eradication requires treatment of both liver and blood stages.
    • P. ovale
      • Can persist in hepatocytes as hypnozoites for months to years
      • Eradication requires treatment of both liver and blood stages.
    • P. malariae
      • Infects older RBCs and causes low-level parasitemia and chronic, low-grade infection
  • P. knowlesi: a monkey malaria parasite, noted to cause human malaria in Southeast Asia, morphologically resembles P. malariae
    • May cause rapidly progressive, severe disease
  • Life cycle: female anopheline mosquito bites human host and injects sporozoites, which invade hepatocytes and mature into schizonts (exo-erythrocytic schizogony), which rupture and release merozoites that invade RBCs. In RBCs, ring stage trophozoites mature into schizonts (erythrocytic schizogony), followed by rupture of RBCs and a new cycle of RBC invasion.

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Last updated: March 1, 2017