Quartan malaria following splenectomy 36 years after infection

Quartan malaria developed following splenectomy 36 years after infection in a 63-year-old hypertensive man. The patient underwent nephrectomy because of left renal calculus, increasing proteinuria and hypertension. Splenectomy was done additionally because metastasis of renal tumor to the spleen was suspected at the operation. Attention is drawn to the long silent infection with Plasmodium malariae and to the importance of the spleen in malaria.