Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco para contrair malária
- presença de fatores de risco para a doença grave
- febre, ou história de febre
Outros fatores diagnósticos
- cefaleia
- fraqueza
- mialgia
- artralgia
- anorexia
- diarreia
- convulsões
- náuseas e vômitos
- dor abdominal
- palidez
- hepatoesplenomegalia
- icterícia
- nível alterado de consciência
- hipotensão
- sangramento
- anuria/oligúria
- taquipneia
Fatores de risco
- viagem para uma área endêmica
- quimioprofilaxia inadequada ou ausente
- mosquiteiro de leito tratado com inseticida usado em área endêmica
- baixa imunidade do hospedeiro (doença grave)
- gestação (doença grave)
- idade <5 anos (doença grave)
- imunocomprometimento (doença grave)
- idade avançada (doença grave)
- administração de ferro (crianças)
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- esfregaços sanguíneos delgados e espessos corados por Giemsa
- testes diagnósticos rápidos (TDRs)
- Hemograma completo
- coagulograma
- eletrólitos, ureia e creatinina séricos
- testes séricos da função hepática
- glicemia sérica
- urinálise
- gasometria arterial
Investigações a serem consideradas
- reação em cadeia da polimerase do sangue para malária
- radiografia torácica
- hemocultura
- urocultura
- cultura de escarro
- punção lombar
- teste de HIV
- reação em cadeia da polimerase de swabs nasofaríngeos para gripe (influenza)
- tomografia computadorizada (TC) do crânio
Novos exames
- ensaio de amplificação circular isotérmica
Algoritmo de tratamento
Plasmodium falciparum: doença não complicada, capacidade de tomar medicamentos por via oral inicialmente
Plasmodium falciparum: doença grave ou incapacidade de tomar medicamentos por via oral inicialmente
Plasmodium ovale
Plasmodium vivax
Plasmodium malariae ou Plasmodium knowlesi
Plasmodium falciparum: infecção recorrente
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 has active grants from a number of organisations; however, none of them are for malaria projects. 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 and was paid by Pfizer to chair a grants committee on antimicrobial stewardship (unrelated to malaria). 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
Wellcome Trust Doctoral Training 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.
O uso deste conteúdo está sujeito ao nosso aviso legal