The Feverish Seaman

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The Feverish Seaman
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• A 22-year-old merchant seaman developed weakness,
  chills and fever while on board ship which had
  departed two weeks previously from a west African
  port.
• In the 4 days following the initial symptoms, he
  became acutely ill with headache, fever (l03F),
  severe diarrhea, abdominal cramps and dyspnea.

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P. Falciparum causes alterations in the RBC
membrane knobs these altered RBCs are
sequestered in the microvasculature and cause the
protean effects of severe malaria (CNS, renal,
pulmonary, etc.)
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P. Falciparum Malaria

• Thick and thin smears x 3 to increase yield
• Frequently severe and often fatal
• Characteristic ring form on thin, and gametocyte
  on thick preparations
• Multiple ring forms favor P. falciparum
  falciparum tends to be a smaller parasite, so
  multiply infected RBCs suggests falciparum over
  other forms
• Banana-shaped gametocytes also noted only in
  falciparum

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