Malaria classification

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Classification by Plasmodium Strain

The following Plasmodium strains are the most common strains implicated in human malarial infection.

Strain

Appearance of Erythrocyte (RBC)	Appearance of Parasite	Clinical Findings
P. falciparum	Normal appearance with Maurer's clefts: Ring, trophozoite, and schizont forms. Distorted appearance: Gametocyte form	Chromatin dots and "appliqué" (accolé): Ring form Clump of mass and dark pigment: Trophozoite and schizont forms Crescent or sausage shape: Gametocyte form	Normal appearance with Maurer's clefts: Ring, trophozoite, and schizont forms. Distorted appearance: Gametocyte form
P. vivax	Normal with fine Schüffner dots: Ring form Enlarged with fine Schüffner dots: Trophozoite, schizont, and gametocyte forms	Large cytoplasm with pseudopods: Ring form Large ameboid cytoplasm with yellow-brown pigment: Trophozite form Large mass that fills all RBC with yellow-brown coalescent pigment: Schizont form Large mass that fills all RBC with scattered brown pigment: Gametocyte form	Normal with fine Schüffner dots: Ring form Enlarged with fine Schüffner dots: Trophozoite, schizont, and gametocyte forms
P. ovale	Normal with fine Schüffner dots	Sturdy cytoplasm and large chromatin: Ring form Compact cytoplasm with dark-brown pigment: Trophozoite form Large nuclei clustered around mass of dark-brown pigment: Schizont form Round to oval form that fills all RBC with scattered brown pigment: Gametocyte form	Normal with fine Schüffner dots
P. malariae	Normal with Ziemann's stippling	Sturdy cytoplasm and large chromatin: Ring form Compact cytoplasm with occasional band forms and coarse dark-brown pigment: Trophozoite form Large nuclei clustered around mass of coarse, dark-brown pigment and occasional rosettes: Schizont form Round to oval form that fills all RBC with scattered brown pigment: Gametocyte form	Normal with Ziemann's stippling
P. knowlesi	Normal with Sinton and Mulligan stippling	Delicate cytoplasm with appliqué (accolé) forms: Ring form Compact cytoplasm and large chromatin with band forms and dark-brown pigment: Trophozoite form Segmented with large nuclei around mass of coarse brown pigment and occasional rosettes: Schizont form Round to oval form that fills all RBC with scattered brown pigment: Gametocyte form	Normal with Sinton and Mulligan stippling

^{Adapted from D’Agati VD, Fogo AB, Bruijn JA, and Jennette JC. Pathological classification of focal segmental glomerulosclerosis. A working proposal. Am J of Kidney Dis. 2004; 43(2):368-382.}