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All of the pathology of malaria is due to parasites multiplying in erythrocytes. The primary attack of malaria begins with headache, fever, anorexia, malaise, and myalgia. This is followed by paroxysms of chills, fever, and profuse sweating. There may be nausea, vomiting, and diarrhea. Such symptoms are not unusual for an infectious disease and it is for this reason that malaria is frequently called “The Great Imitator”.
Depending on the species, the paroxysms tend to assume a characteristic periodicity. In P. vivax, P. ovale and P. falciparum the periodicity is 48hr and for P. malariae the periodicity is 72 hours.