Other pathological processes in malaria.

Abstract

Research since the World War II has confirmed that, apart from the production of haemozoin from haemoglobin, most of the pathological processes in the evolution of malaria are nonspecific. A few of these nonspecific host reactions are discussed, including the production of inflammatory stasis in certain areas (including the brain) where the vascular endothelium is normally highly impermeable to heavy molecules. This production of stasis is regarded as the basic phenomenon in local obstruction to blood flow. So-called "plugging" of small vessels with "sticky" infected erythrocytes is discussed in relation to stasis and to deep intravascular schizogony. Nonspecific vasomotor effects including shock and renal and hepatic failure are also discussed. Intravascular coagulation is not regarded as a potentially important host response despite demonstrable consumption coagulopathy. The disease malaria is regarded as an example of a chain reaction of physiological-pathological responses in the host, which in the early stages are reversible.