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Malaria

Última revisão: 20 Aug 2025
Última atualização: 17 Jan 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • fever or history of fever
Detalhes completos

Outros fatores diagnósticos

  • headache
  • weakness
  • myalgia
  • arthralgia
  • anorexia
  • diarrhea
  • seizures
  • nausea and vomiting
  • abdominal pain
  • pallor
  • hepatosplenomegaly
  • jaundice
  • altered level of consciousness
  • hypotension
  • bleeding
  • anuria/oliguria
  • tachypnea
Detalhes completos

Fatores de risco

  • travel to endemic area
  • inadequate or absent chemoprophylaxis
  • insecticide-treated bed net not used in endemic area
  • low host immunity (severe disease)
  • pregnancy (severe disease)
  • age <5 years (severe disease)
  • immunocompromise (severe disease)
  • older age (severe disease)
  • malnutrition (severe disease)
  • iron administration (children)
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • Giemsa-stained thick and thin blood smears
  • rapid diagnostic tests (RDTs)
  • CBC
  • clotting profile
  • serum electrolytes, BUN and creatinine
  • serum LFTs
  • serum blood glucose
  • urinalysis
  • arterial blood gas
Detalhes completos

Investigações a serem consideradas

  • polymerase chain reaction (PCR) blood for malaria
  • chest x-ray
  • blood culture
  • urine culture
  • sputum culture
  • lumbar puncture
  • HIV test
  • PCR nasopharyngeal swabs for influenza or COVID-19
  • CT head
Detalhes completos

Novos exames

  • loop-mediated isothermal amplification

Algoritmo de tratamento

AGUDA

severe disease (or unable to take oral medication initially): all Plasmodium species

Plasmodium falciparum (or unknown species): uncomplicated disease

Plasmodium ovale: uncomplicated disease

Plasmodium vivax: uncomplicated disease

Plasmodium malariae or Plasmodium knowlesi: uncomplicated disease

CONTÍNUA

Plasmodium falciparum: recurrent infection

Colaboradores

Autores

Elizabeth Ashley, MB BS, FRCP, FRCPath

Director

Institution Lao-Oxford-Mahosot Hospital - Wellcome Trust Research Unit

Vientiane

Laos

Honorary Consultant in Infectious Diseases and Microbiology

Oxford University Hospitals NHS Foundation Trust

Professor of Tropical Medicine

University of Oxford

Oxford

UK

Declarações

EA is an associate editor of Malaria Journal, an academic editor for PLOS Medicine, and is on the Lancet Infectious Diseases International Advisory Board. EA is on the council of the International Society for Infectious Diseases. The Institution Lao-Oxford-Mahosot Hospital - Wellcome Trust Research Unit receives core funding from the Wellcome Trust. EA is an author of a number of references cited in this topic.

Arjun Chandna, BA MRCP AFHEA

Clinical Research Fellow

Centre for Tropical Medicine and Global Health

University of Oxford

Oxford

Specialty Registrar in Infectious Diseases and Medical Microbiology

University College London Hospitals NHS Trust

London

UK

Declarações

None.

Agradecimentos

Dr Elizabeth Ashley and Dr Arjun Chandna would like to gratefully acknowledge Professor Ron Behrens, Mariyam Mirfenderesky, Dr Signe Maj Sorensen, Dr Joanna Allen, Dr Simon Warren, and Dr Behzad Nadjm, previous contributors to this topic.

Declarações

RB acted as a paid expert to the courts on malaria prophylaxis. RB received fees on the Travel Health advisory board for Emergent BioSolutions. RB prepared education material for the Royal College of Physicians and Surgeons of Glasgow. RB is an author of a number of references cited in this topic. MM, SMS, JA, and SW declare that they have no competing interests. BN is an author of a reference cited in this topic.

Revisores

Blaise Genton, MD

Professor

Head of the Travel Clinic

Consultant of Tropical and Travel Medicine

University Hospital

Project Leader

Swiss Tropical and Public Health Institute

Basel

Switzerland

Declarações

BG has received a research grant from Novartis Pharma to assess the impact of the introduction of artemether-lumefantrine (Novartis) as first-line treatment for uncomplicated malaria on mortality of children under 5 years old in 2 districts in Tanzania and travel grants from Novartis Pharma to present the results of the study above. BG is an author of a reference cited in this topic.

David Sullivan, MD

Associate Professor

Malaria Research Institute and Department of Molecular Microbiology and Immunology

Johns Hopkins Bloomberg School of Public Health

Baltimore

MD

Declarações

DS has received royalties from antigen provision for a diagnostic test to Inverness. DS with Johns Hopkins University has patents on diagnostic tests that do not require blood.

Walther H. Wernsdorfer, MD

Professor

Institute of Specific Prophylaxis and Tropical Medicine

Medical University of Vienna

Vienna

Austria

Declarações

WHW declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

World Health Organization. WHO guidelines for malaria. Nov 2024 [internet publication].Texto completo

Centers for Disease Control and Prevention. Clinical guidance: malaria diagnosis & treatment in the U.S. Jun 2024 [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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