Typical : Sudden onset of High Fever with rigors and sensation of extreme
colds followed by feeling of burning, leading to profuse sweating and remission
of fever by crisis thereafter. The febrile paroxsyms occur every alternate
day. Headache, body ache, nausea etc. may be associated features.
Atypical : In atypical cases, classical presentation as mentioned
above may not manifest. Hence, any fever case until unless proved otherwise,
may be considered as malaria in the endemic areas during transmission
season.
In most of the cases, the first symptoms are not specific and similar
to those of a minor viral illness with malaise, headache, fatigue,
abdominal discomfort and muscle aches followed by fever and chills.
Repeated infections lead to anaemia, enlargement of spleen, and chronic
ill health with bouts of fever,. Most patients with uncomplicated acute
infection have few abnormal physical findings other mild anaemia and
in some cases a palpable spleen. None of the clinical features of malaria
is pathognomic.
Severe & complicated malaria : Children : The signs & symptoms in children are a history of high
fever plus at least one of the following.
1. Prostration (inability to sit), altered consciousness lethargy or
coma,
2. breathing difficulties,
3. severe anaemia,
4. convulsions,
5. inability to drink / vomitting.
Adults : The same symptoms & signs in children
are valid for adults, with addition of dark and / or limited production
of urine. 1. Hypoglycaemia
2. Shock
3. Hyperpyrexia (Rectal temperature above 390c)
4. Dehydration
5. Acute Renal failure with anuria or oliguria and black water fever.
6. Hyperkalaemia / Hypo kalaemia
7. Pulmonaty Oedema
8. GAstro intestinal complications.
9. Bleeding (pulmonary oedema )
10. Jaundice & lever damage.
11. Hyperparasitaemia
Differences between presentation of severe malaria in adults and in
children.
