Walsh & Hoyt: Pathogenesis

Neither sporozoites nor exoerythrocytic forms nor even gametocytes are directly deleterious to the host; only the asexual intraerythrocytic parasites cause disease. The pathogenic mechanisms that produce clinical illness usually are separated into four processes: (a) fever and its physiologic consequences; (b) anemia; (c) tissue hypoxia resulting from anemia and alterations in the microcirculation; and (d) initiation of immunopathologic events.