Heck J E
University of Cincinnati, College of Medicine, Ohio.
Prim Care. 1991 Mar;18(1):195-211.
Human malaria is caused by four species of the genus plasmodium. The sexual stage of the parasite occurs in the mosquito and asexual reproduction occurs in man. Symptoms of fever, chills, headache, and myalgia result from the invasion and rupture of erythrocytes. Merozoites are released from erythrocytes and invade other cells, thus propagating the infection. The most vulnerable hosts are nonimmune travelers, young children living in the tropics, and pregnant women. P. falciparum causes the most severe infections because it infects RBCs of all ages and has the propensity to develop resistance to antimalarials. Rapid diagnosis can be made with a malarial smear, and treatment should be initiated promptly. In some regions (Mexico, Central America except Panama, and North Africa) chloroquine phosphate is effective therapy. In subsaharan Africa, South America, and Southeast Asia, chloroquine resistance has become widespread, and other antimalarials are necessary. The primary care physician should have a high index of suspicion for malaria in the traveler returning from the tropics. Malaria should also be suspected in the febrile transfusion recipient and newborns of mothers with malaria.
人类疟疾由疟原虫属的四种寄生虫引起。寄生虫的有性阶段发生在蚊子体内，无性繁殖发生在人体中。发热、寒战、头痛和肌痛等症状是由红细胞的入侵和破裂引起的。裂殖子从红细胞中释放出来并侵入其他细胞，从而传播感染。最易感染的宿主是非免疫旅行者、生活在热带地区的幼儿和孕妇。恶性疟原虫会引发最严重的感染，因为它能感染所有年龄段的红细胞，并且有对抗疟药物产生耐药性的倾向。通过疟原虫涂片可进行快速诊断，治疗应迅速开始。在一些地区（墨西哥、除巴拿马外的中美洲和北非），磷酸氯喹是有效的治疗药物。在撒哈拉以南非洲、南美洲和东南亚，氯喹耐药性已广泛传播，需要使用其他抗疟药物。基层医疗医生对从热带地区归来的旅行者患疟疾应保持高度怀疑。对于发热的输血接受者以及患有疟疾的母亲所生的新生儿，也应怀疑患有疟疾。
