Patogenesis Malaria

Patogenesis, Patofisiologi, GK
Harrison.Prinsip- prinsip Ilmu Penyakit Dalam.Ed13
www.emedecinemedscape.com
IPD UI
Deitsch KW, Wellems TE. Membrane modifications in erythrocytes parasitized. Mol Biochem Parasitol. 1996 ;76 : 1-10

Devina 1210008
Siklus dalam tubuh manusia

sporozoit
Sel hepatosit
Skizon immature
Skizon mature
(10.000-30.000 merozoit)
Sel hepatosit pecah
Merozoit ke aliran darah
Invasi eritrosit (retikulosit)
(diperantarai o/
rec.pmk eritrosit spes)*
Parasit menguraikan prot intrasel scr progresif (Hb) **
Hemolisis
pRBC
anemia
Filtrasi + f(x) imunologi
Fagositosis di lien
Destruksi eritrosit
Timbunan penghancuran parasit, pigmen, sel radang (makrofag,monosit,limfosit), jar.ikat
splenomegali
Aktivasi Makrofag, Monosit
Sitokin (TNF, IL-1, IL-6, IL-8,INF-g)
Febris
(suhu > 40 C , menggigil)
Imun humoral (IgM, IgG,IgA)
& seluler
Batasi replikasi parasit in vivo
Parasitemia ekspresi adh. Mol
(ICAM 1, VCAM 1, CD 36)
LDL teroksidasi
Cyto-
adherence
endotel
Cytoadherence trombosit
& Leukosit (monosit)
trombositopenia
Fagositosis o/ makrofag
Gejala Klinis
Gejala Prodromal (2-3 hari)
Malaise, myalgia, sakit kepala, anorexia, panas sedikit meningkat.
Periodisitas :
Panas irreguler, intermitten 5-7 hari
Berlanjut dengan febrile paroxysm (P.vivax & P.ovale 48 jam tertian periodicity)
Didahului dengan dingin, menggigil (early afternoon) 30-60' dilanjutkan dengan panas tinggi (39-40 C) selama 2-6 jam, kemudian berkeringat (sweating stage) selama 2-3 jam lalu normal.
Keadaan ini disertai sakit kepala, nausea, vomitus, diare, muka merah, batuk kering.




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Pelepasan merozoit + pigmen malaria + debris

3
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