Falciparum malaria in naturally infected Saudi patients: fine structure of intraerythrocytic gametocytes and their effects on host cell alterations: a comparison with those from various geographic regions

The fine structure of intraerythrocytic mature gametocytes [MG] was described in naturally infected Saudi patients [SP] from Tihama Valley, Asir Province, the most endemic region of falciparum malaria in the kingdom of Saudi Arabia and compared with those previously reported in vivo and in vitro MG from various geographic regions. In addition, the ultrastructural alterations of host cells infected with MG were also considered. The most striking finding in this study was that the MG cell wall from Saudi patients consisted of only a single plasma membrane, i.e. monolayer, without subpellicular microtubules [Sp Mt], while it was triand pentalaminar with Sp Mt in MG from other geographic regions. Unlike other MG, mitochondria, Golgi bodies and vacuoles have not been observed in parasites found in SP. As in some MG, the malaria pigment particles found in parasites from SP were embedded directly in the cytoplasm, while in other MG, they were enclosed in sizable vacuoles. The alterations induced in erythrocytes by MG from SP were similar to those found in MG from various geographic regions and include clefts, laveran's "bibs", a multilaminar membranous system and condensation of the host cell cytoplasm

Falciparum malaria in naturally infected Saudi patients: high level endotoxemia in the venous blood infected with escherichia coli

During examination by transmission electron microscopy [TEM] of venous blood samples from twelve Saudi patients who were heavily infected with the human falciparum malaria parasite, three blood samples [25%] were found to contain numerous single, rod-shaped microorganism-like bacteria. Bacteriological tests identified these microorganisms as Escherichia coil, their confident limit of identification being 98%. Examination by TEM of the cultured bacteria has also identified their typical ultrastructural features. Detection of E. coli in the three blood samples has encouraged the examination for the occurence of endotoxaemia by the amoebocyte limulus lysate test. Endotoxin was likely detected and its level was found to be remarkably higher in blood samples infected with both the malaria parasite and bacteria than those only infected with the parasite, while none was detected in samples from five healthy volunteers. These findings suggest the possible responsibility of E. coli in increasing the endotoxaemia level in the blood of patients infected with falciparum malaria