Quartan fever is one of the four types of malaria which can be contracted by humans.It is specifically caused by the Plasmodium malariae species, one of the six species of the protozoan genus Plasmodium. Quartan fever is a form of malaria where an onset of fever occurs in an interval of three to four days, hence the name "quartan". It is transmitted by bites of infected female mosquitoes of the genus Anopheles. Symptoms include fevers which range from approximately 40–41 °C (104–106 °F) and occur periodically in 72 hour intervals. Although cases of malaria have occurred throughout the world, quartan fever typically occurs in the subtropics. Quartan fever is considered to be a less severe form of malaria fever that can be cured by anti-malarial medication, and prevention methods can be taken in order to avoid infection. Cause
The female Anopheles mosquito is a vector which transmits quartan fever to people. Mature mosquitoes carry uninucleate sporozoites in their salivary glands; these sporozoites enter a humans bloodstream when mosquitoes puncture human flesh during feeding. Sporozoites attack and inhabit liver parenchymal cells, called hepatocytes, in order to develop further. Once the uninucleate sporozoites have matured, the sporozoites then develop into uninucleate merozoites. Uninucleated merozoites mature into an erythrocytic stage called schizonts which contain merozoites. The schizonts, an infected erythrocyte, then rupture to release these merozoites; leading to more infections in the red blood cells.
Erythema marginatum is a type of erythema (redness of the skin or mucous membranes) involving pink rings on the torso and inner surfaces of the limbs which come and go for as long as several months. It is found primarily on extensor surfaces.An association with bradykinin has been proposed in the case of hereditary angioedema. Presentation
The rings are barely raised and are non-itchy. The face is generally spared. Associated conditions
It occurs in less than 5% of patients with rheumatic fever, but is considered a major Jones criterion when it does occur. The four other major criteria include carditis, polyarthritis, Sydenhams chorea, and subcutaneous nodules. In this case, it is often associated with Group A streptococcal infection, otherwise known as Streptococcus pyogenes infection, which can be detected with an ASO titer.It is an early feature of rheumatic fever and not pathognomonic of it. It may be associated with mild myocarditis (inflammation of heart muscle). It is also seen in conditions like allergic drug reactions, sepsis and glomerulonephritis.It often occurs as a harbinger of attacks in hereditary angioedema. In this case it may occur several hours or up to a day before an attack. Diagnosis
Types
Some sources distinguish between the following:
"Erythema marginatum rheumaticum"
"Erythema marginatum perstans"

Treatment
Erythema marginatum can be treated with hydrocortisone and adrenocorticotropc hormone (ACTH). References


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