When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Malaria

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

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • presencia de factores de riesgo para contraer la malaria
  • presencia de factores de riesgo de enfermedad grave
  • Fiebre o antecedentes de fiebre
Detalhes completos

Outros fatores diagnósticos

  • cefalea
  • debilidad
  • mialgia
  • artralgia
  • anorexia
  • diarrea
  • convulsiones
  • náuseas y vómitos
  • dolor abdominal
  • palidez
  • hepatoesplenomegalia
  • ictericia
  • nivel de alteración de la consciencia
  • hipotensión
  • sangrado
  • anuria/oliguria
  • taquipnea
Detalhes completos

Fatores de risco

  • viaje a zona endémica
  • quimioprofilaxis inadecuada o no realizada
  • ausencia de mosquiteros tratados con insecticidas en las zonas endémicas
  • baja inmunidad del huésped (enfermedad grave)
  • embarazo (enfermedad grave)
  • edad <5 años (enfermedad grave)
  • Compromiso inmunológico (enfermedad grave)
  • edad avanzada (enfermedad grave)
  • desnutrición (enfermedad grave)
  • administración de hierro (niños)
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • frotis de gota fina y gruesa preparados con tinción de Giemsa
  • pruebas diagnósticas rápidas (PDR)
  • hemograma completo (HC)
  • perfil de coagulación
  • urea, creatinina y electrolitos séricos
  • pruebas de función hepática (PFH) séricas
  • glucosa sérica
  • análisis de orina
  • gasometría arterial
Detalhes completos

Investigações a serem consideradas

  • reacción en cadena de la polimerasa (PCR) en sangre para malaria
  • radiografía de tórax
  • hemocultivo
  • urocultivo
  • cultivo de esputo
  • punción lumbar
  • prueba del VIH
  • Hisopados nasofaríngeos por PCR para gripe o COVID-19
  • TC craneal
Detalhes completos

Novos exames

  • amplificación isotérmica mediada por bucles

Algoritmo de tratamento

AGUDA

enfermedad grave (o incapacidad para tomar medicación oral inicialmente): todas las especies de Plasmodium

Plasmodium falciparum (o especie desconocida): enfermedad sin complicaciones

Plasmodium ovale: enfermedad sin complicaciones

Plasmodium vivax: enfermedad sin complicaciones

Plasmodium malariae o Plasmodium knowlesi: enfermedad sin complicaciones

CONTÍNUA

Plasmodium falciparum: infección recurrente

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

Disclosures

None.

Acknowledgements

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.

Disclosures

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.

Peer reviewers

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

Disclosures

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

Disclosures

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

Disclosures

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

World Health Organization. WHO guidelines for malaria. Nov 2024 [internet publication].Full text

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

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Malaria images
  • Differentials

    • Dengue
    • Infección por el virus Zika
    • virus Chikungunya
    More Differentials
  • Guidelines

    • Management of treatment failure (recrudescence) in falciparum malaria
    • Malaria diagnosis and treatment in the US
    More Guidelines
  • Patient information

    Prevención de la malaria

    More Patient information
  • Videos

    Punción lumbar diagnóstica en adultos: demostración animada

    More videos
  • padlock-lockedInicie sesión o suscríbase para acceder a todo el BMJ Best Practice

El uso de este contenido está sujeto a nuestra cláusula de exención de responsabilidad