So-called choleriform and dysenteric manifestations of perniciousness of the algid type are rarely observed.
Cases with the clinical picture of acute haemorrhagic pancreatitis have been reported as incident to excessive sporulation of malarial parasites in the capillaries of the pancreas.
The Respiratory System.—There may be a slight bronchitis in ordinary types of malarial fever. In the cerebral types of perniciousness the breathing may be markedly altered—even of Cheyne-Stokes character.
Fig. 21.—Malarial cachexia. (Deaderick.)
A broncho-pneumonia which shows a periodicity and responds to quinine is often considered as a pernicious type of malaria.
The Skin.—Herpes labialis is a common manifestation of benign tertian and not rarely of malignant tertian infection. Urticaria may also be noted. The skin of malarial cachexia is earthy. Of course, one must always keep in mind the skin eruptions due to quinine administered in treatment, and of these urticaria is probably the most frequent.
The Nervous System.—In both the benign and malignant infections headache is a marked feature and is accentuated during the hot stage. There may be a “flighty” condition in the hot stage of benign tertian and quartan but in aestivo-autumnal infections there may be actual delirium.
Delirious and comatose states are prominent features of cerebral pernicious attacks. At times there may be an apathetic condition suggesting typhoid fever.
Almost any type of central nervous system disease may be simulated as the result of focal sporulation so that we have aphasic, epileptiform, hemiplegic, bulbar and other clinical types.