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Malaria Falciparum: Relapse After a Decade
Shriya Doreswamy1, Hussein Al Sudani1
1Internal Medicine, Einstein Medical Center Montgomery, East Norriton, USA.
Cureus
|August 15, 2022
Summary
A rare case of relapsed malaria occurred 10 years after initial treatment in a traveler returning to the US. This highlights the potential for dormant Plasmodium malaria parasites to cause late-stage infections without re-exposure.
Area of Science:
- Infectious Diseases
- Tropical Medicine
- Parasitology
Background:
- Malaria, caused by Plasmodium parasites, remains a global health concern.
- While preventable and treatable, imported malaria cases occur annually in non-endemic regions like the United States.
- Transmission routes include mosquito bites, blood products, and vertical transmission.
Observation:
- A 31-year-old female presented with symptoms of abdominal pain, fever, and headache.
- She had a history of treated malaria from Liberia ten years prior.
- No risk factors for re-infection or typical relapse were identified.
Findings:
- The patient was diagnosed with a Plasmodium malaria infection relapse.
- Treatment involved a 14-day course of primaquine (300 mg daily).
- Symptoms resolved within days of commencing treatment.
Implications:
- This case underscores the possibility of long-term dormancy of Plasmodium malaria parasites.
- It highlights the importance of considering malaria relapse in travelers with a remote history, even years later.
- Further research into the mechanisms of dormant parasite evasion and late relapse is warranted.
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