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Sporozoites are injected into the blood stream of a person by the femal anopheles mosquito. They go straight to the hepatocytes, to form a cystic structure known as a schizont. In 1 - 2 weeks this ruptures releasing hundreds of infective meroizoites in the blood. These merozoites are highly immunogenic, causing the circulating neutrophils and macrophages of the reticulo-endothelial system to release large number of cytokines, and other inflammatory mediators. In particular IL-6 and TNF. These cause the fever with chills and shivering. Some of the merozoites are sequestered by the reticulo-endothelial system. The majority left over infect other red blood cells. Inside the cells they divide, rupture the cell and release another 20 or so merozoites per organism. In this process large number of red blood cells are destroyed resulting in anemia, and hemoglobin in the blood and urine. The red blood cells also become fragile, are destroyed by the spleen, and there is hypersplenism (enlarged spleen). Fragile, infected red blood cells can also lodge in vessels causing damage to that particular organ. This is of major significance in the brain where cerebral malaria can result

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14y ago

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