Hepatic fatty metamorphosis in latent exoerythrocytic malaria

We report a child with asymptomatic latent exoerythrocytic Plasmodium vivax malaria whose initial presentation was only hepatomegaly and elevated serum lipids. Histology of the liver showed severe fatty metamorphosis. Liver size and the severe fatty metamorphosis decreased markedly with the return of serum lipids to normal after successful treatment of P. vivax. Although this association has been reported in monkeys infected with P. knowlesi, this is the first report of such an association in humans.