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File: 123096_sep96_decls23_0024.txt
Subject: DIAGNOSIS AND TREATMENT OF DISEASES OF IMPORTANCE
Unit: OTSG
Parent Organization: HSC
Box ID: BX003203
Folder Title: DIAGNOSIS AND TREATMENT OF DISEASES 1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS
Document Number: 1
Folder Seq #: 88
II. Incubation: 2. chemistries:
a. Hypoglycemia (may be severe, even after
A. -P Ici arum: 12 days (range 9-14). treatment.
b. Electrolyte abnormalities, including hyper-
B. P. vivax: 14 days (range 12 days - 10 months), kalemia, from RBC lysis.
C. Elevated transaminases (alkaline phosphatase
111. Diagnosis: normal).
d. Azotemia (pre-renal).
A. Symptoms: a. Hyperbilirubinemia.
I . Syndrome of malaise, fatigue and myalgia may 3. Urinalysis: generally normal, small amounts of
precede febrile paroxysm by several days. proteinuria may occur.
2. Abrupt onset: fevers, chills/rigors, profuse 4. microbiologic: standard techniques are not ap-
sweats, headache, backache, nyalgia, abdominal plicable.
5. Serology:
and profuse in P. alci a um. a. Biologic false positive VDRL may occur.
b. Specific malarial serologic tests exist, but
B. Signs: are of epidemiologic, not clinical, value.
1. Intermittent fever to > 40@ (105@) . Fever may 6. Coagulation:
be almost continuous in P. ci arum malaria; a. Generally normal, but prolonged prothrombin
classic -'periodicity" is-frequently absent, time (PT) and partial thromboplastin time
Profuse sweating between febrile paroxysms. (APPT) may be seen.
Tachycardia, orthostatic hypotension, tender b. Disseminated intravascular coagulation (DIC)
hepatomegaly, moderate splenomegaly, delirium occurs, but uncommonly.
(during fever). D. X-ray: nonspecific.
2. Less common: jaundice, petechiae, urticaria,
conjunctival injection, retinal vasospasm/hemor- E. invasive procedures:
rhage. 1. Not specifically indicated.
2. Lumbar puncture to assess mental status or neuro-
1. Hematologic: logic changes may show elevated opening pressure
a. Intra-erythrocytic parasites on smears of but will be otherwise normal in the absence of
peripheral blood. cerebral malaria.
i) thin smears: prepare film as for normal 3. Lumbar puncture in cerebral malaria may show
CBC, fix in methanol, use Giemsa stain. increased opening pressure, increased protein and
ii) thick smear-one drop of blood on a pleocytosis, but glucose is usually normal.
slide; with glass slide corner spread P. Diagnostic confirmation: identification of parasite oii
drop until it is about dime size, and blood smears.
print on paper below slide/smear can IV. Duration:
barely be seen; stain with Giemsa stain
after well dried. DO NOT FIXI A. Treated: 3 days in uncomplicated cases. May recru-
iii) thick smear more sensitive (about 2ox) desce within 4 weeks if parasite drug resistant.
for identifying parasite presence, thin
iden- B. Untreated:
tification. 1. P. falciparum often rapidly fatal in untreated
iv) smear must be obtained several times/day
for several days to rule out malaria. non-immune patients and may recrudesce Up to 2 - 4
b. Anemia (normochromic, normocytic, hemolytic). years.
C. Leukopenia. 2. P. vivax is rarely fatal but may relapse up to 8
d. Monocytosis (> 10%). years.
e. Eosinophilia not seen.
f. Thrombocytopeiiia (to < 50,000/mm@
38 39
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Document 52 f:/Week-36/BX003203/DIAGNOSIS AND TREATMENT OF DISEASES 1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS/diagnosis and treatment of diseases of importanc:12179609281524
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003203
Unit = OTSG
Parent Organization = HSC
Folder Title = DIAGNOSIS AND TREATMENT OF DISEASES 1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS
Folder Seq # = 88
Subject = DIAGNOSIS AND TREATMENT OF DISEASES OF IMPORTANC
Document Seq # = 1
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 17-DEC-1996