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A case of imported Plasmodium malariae malaria
Yun Ji Hong1, Sun Young Yang, Kyunghoon Lee
1Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea.
Annals of Laboratory Medicine
|May 8, 2012
Summary
A malaria case in Ghana revealed a P. malariae infection that recurred after initial treatment. This suggests a possible chloroquine-resistant strain, highlighting the need for vigilant monitoring and alternative therapies.
Area of Science:
- Tropical Medicine
- Infectious Diseases
- Parasitology
Background:
- Malaria is a significant global vector-borne parasitic disease caused by Plasmodium species.
- Plasmodium vivax and Plasmodium falciparum are the most prevalent malaria species worldwide.
- Plasmodium malariae and Plasmodium ovale cause a smaller percentage of malaria cases.
Observation:
- A 23-year-old Korean woman contracted Plasmodium malariae malaria during a business trip to Ghana, West Africa.
- Diagnosis was confirmed using peripheral blood smear (PBS) and molecular assays (18S rRNA PCR).
- Initial hydroxychloroquine treatment appeared successful, with negative conversion on day 2 PBS.
Findings:
- Recurrent parasitemia was detected via PBS and molecular testing at the 1-month follow-up.
- The patient was successfully treated with rescue therapy using mefloquine.
- This case suggests a potential late recrudescence of a chloroquine-resistant P. malariae strain.
Implications:
- This finding underscores the possibility of chloroquine resistance in Plasmodium malariae.
- It highlights the importance of considering drug resistance in malaria treatment and follow-up.
- Vigilant monitoring and molecular diagnostics are crucial for managing recurrent malaria cases.
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