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Microbiology ` microbiology—Parasitology Microbiology ` microbiology—Parasitology SEcTioN ii 157

Protozoa—hematologic infections
orgaNism Disease traNsmissioN DiagNosis treatmeNt
Plasmodium Malaria—fever, headache, anemia, Anopheles mosquito Blood smear: Chloroquine (for
P vivax/ovale splenomegaly trophozoite ring sensitive species);
P falciparum P vivax/ovale—48-hr cycle (tertian; form within if resistant, use
P malariae includes fever on first day and RBC A , schizont mefloquine or
A third day, thus fevers are actually containing atovaquone/
48 hr apart); dormant form merozoites; red proguanil
(hypnozoite) in liver granules (Schüffner If life-threatening,
P falciparum—severe; irregular stippling) B use intravenous
fever patterns; parasitized RBCs throughout RBC quinidine or
occlude capillaries in brain cytoplasm seen artesunate (test for
(cerebral malaria), kidneys, lungs with P vivax/ovale G6PD deficiency)
B
P malariae—72-hr cycle (quartan) For P vivax/ovale,
add primaquine for
hypnozoite (test for
G6PD deficiency)

Babesia Babesiosis—fever and hemolytic Ixodes tick (also Blood smear: ring Atovaquone
C anemia; predominantly in vector for Borrelia form C1 , “Maltese + azithromycin
northeastern United States; burgdorferi and cross” C2 ; PCR
asplenia  risk of severe disease Anaplasma spp)

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