Late relapse of imported Plasmodium ovale malaria: a case report

##plugins.themes.academic_pro.article.sidebar##

Published Oct 26, 2015
Download
pdf
Vol. 93 No. 6 (2015): Issue Jun 2015

##plugins.themes.academic_pro.article.main##

Emna Siala
Mondher Gastli
Rym Essid
Sana Jemal
Rym Ben Abdallah
Imène Ben Abda
Karim Aoun
Aida Bouratbine

Abstract

We report the first case of an imported Plasmodium ovale relapse in a Tunisian man who developed malaria three years after leaving sub- Saharan Africa.
A 29-year-old Tunisian man consulted in September 2011 because of a fever, myalgia, and headache that had begun eight days earlier and persisted despite treatment with oral antibiotics. On questioning, the patient stated that he had resided three years ago for six months in Ivory Coast, where he acquired malaria. He was treated with artemether-lumefantrine. The patient said he had no recent travel to any other malaria-endemic area and had not received a blood transfusion. A first microscopy of peripheral blood smears was negative for malaria parasites. The diagnosis was established 17 days after onset of symptoms. A repeat microscopic examination of blood smears confirmed the presence of Plasmodium ovale with a parasitemia lower than 0.1%. The patient was treated with artemether lumefantrine, followed by primaquine. This case emphasizes the possibility of relapse of some plasmodial species. It highlights the importance of repeating microscopic examination of blood when the diagnosis of malaria is suspected.

Keywords:

Malaria, Plasmodium ovale, relapse, primaquine

##plugins.themes.academic_pro.article.details##

References

  1. Lee KS, Cox-Singh J, Brooke G, Matusop A, Singh B. Plasmodium knowlesi from archival blood films: Further evidence that human infections are widely distributed and not newly emergent in Malaysian Borneo. Int J Parasitol 2009; 39:1125-8.
  2. Casalino E. Paludisme. Encycl Méd Chir, Médecine 2004; 580-91.
  3. Collins WE, Jeffery GM. Plasmodium ovale: Parasite and Disease. Clin Microbiol Rev 2005; 18: 570-81.
  4. Snounou G, Viriyakosol S, Zhu XP, et al. High sensitivity of detection of human malaria parasites by the use of nested polymerase chain reaction. Mol Biochem Parasitol 1993; 61:315-20.
  5. Bottieau E, Clerinx J, Van Den Enden E, et al. Imported non-Plasmodium falciparum malaria: a five-year prospective study in a European referral center. Am J Trop Med Hyg 2006; 75:133-8.
  6. Hulden LA, Heliövaara K. Natural relapses in vivax malaria induced by Anopheles mosquitoes. Malar J 2008; 7:64.
  7. Richter J, Franken G, Mehlhorn H, Labisch A, Häussinger D. What is the evidence for the existence of Plasmodium ovale hypnozoites? Parasitol Res 2010, 107:1285-90.
  8. D'ortenzio E, Godineau N, Fontanet A, Houze S, Bouchaud O, Matheron S. Prolonged Plasmodium falciparum infection in immigrants, Paris. Emerg Infect Dis 2008; 4:323-6.
  9. Siala E, Khalfaoui M, Bouratbine A, Hamdi S, Hili K ET Aoun K. Relapse of Plasmodium malariae malaria 20 years after living in an endemic area. Presse Med 2005; 34:371-2.
  10. Bottieau E, Clerinx J, Van Den Enden E, et al. Imported non-Plasmodium falciparum malaria: a five-year prospective study in a European referral center. Am J Trop Med Hyg 2006; 75:133-8.
  11. Yvonne AL, Rohela M, Ching C, Thiruventhiran T, Kek C. Plasmodium ovale infection in Malaysia: first imported case. Malar J 2010; 9:272.
  12. CDC. Travelers' health: yellow book. Health information for international travel 2005-- 2006. Atlanta, GA: US Department of Health and Human Services, CDC; 2005. Available at http://wwwn.cdc.gov/travel/yb/index.htm
  13. Marty P, Chapdelaine B, Le Fichoux Y, Chabert JM. Anemic Plasmodium ovale malaria after 45 months' incubation. Presse Med 1987; 16:357. 14. Hill DR, Baird JK, Parise ME, Lewis LS, Ryan ET, Magill AJ. Primaquine: report from CDC expert meeting on malaria chemoprophylaxis I. Am J Trop Med Hyg 2006; 75:402-15.
  14. Hill DR, Baird JK, Parise ME, Lewis LS, Ryan ET, Magill AJ. Primaquine: report from CDC expert meeting on malaria chemoprophylaxis I. Am J Trop Med Hyg 2006; 75:402-15.
  15. Oliver M, Simon F, De Monbrison F, et al. New use of primaquine for malaria. Med Mal Infect 2008; 38:169-79.
  16. Coldren RL, Jongsakul K, Vayakornvichit S, Noedl H, Fukudas MM. Apparent relapse of imported Plasmodium ovale malaria in a pregnant woman. Am J Trop Med Hyg 2007; 77:992-4.
  17. Calderaro A, Piccolo G, Perandin F, et al. Genetic polymorphisms influence Plasmodium ovale PCR detection accuracy. J Clin Microbiol 2007; 45:1624-7.
  18. Grobush M P, Hanscheid T, Zoller T, Jelinek T, Burchard GD. Rapid immunochromatographic malaria antigen detection unreliable for detecting Plasmodium malariae and Plasmodium ovale. Eur J Clin Microbiol Infect Dis 2002; 21:818-20.
  19. Talman AM, Duval L, Legrand E, et al. Evaluation of the intra- and interspecific genetic variability of Plasmodium lactate dehydrogenase. Malar J 2007; 6:140.