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Am. J. Trop. Med. Hyg., 68(2), 2003, pp. 159-160
Copyright © 2003 by The American Society of Tropical Medicine and Hygiene

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CASE REPORT: AN UNUSUAL LATE RELAPSE OF PLASMODIUM VIVAX MALARIA

EMANUELE DURANTE MANGONI, CARLO SEVERINI, MICHELA MENEGON, ROBERTO ROMI, GIUSEPPE RUGGIERO, AND GIANCARLO MAJORI
Dipartimento di Medicina Interna, Seconda Università di Napoli, Naples, Italy; Laboratorio di Parassitologia, Istituto Superiore di Sanità, Rome, Italy

 

ABSTRACT

We observed an unusual case of Plasmodium vivax malaria who presented with an initial relapse four years after the primary infection. This occurred in Cameroon, where the patient, a 56-year-old priest, acquired a mild form of malaria and was treated with only chloroquine. Since he returned to Italy, he had not experienced any malaria-like symptoms, had not visited any other areas endemic for malaria, and had not received a blood transfusion. Blood smear microscopy confirmed the presence of Plasmodium spp. parasites, but unclear morphologic characteristics did not allow discrimination between P. vivax and P. ovale. A nested polymerase chain reaction-based molecular analysis identified P. vivax as the plasmodial species responsible. This case emphasizes the importance of taking into account the possibility of a very late initial relapse of P. vivax malaria and the relevant issues in terms of infection control.

Received January 28, 2002. Accepted for publication October 2, 2002.

Acknowledgment: We are grateful to Dr. Riccardo Utili for helpful discussions and assistance with the preparation of the manuscript.

Financial support: This work was supported by a grant of Istituto Superiore di Sanità (Rome, Italy).

Authors’ addresses: Emanuele Durante Mangoni and Giuseppe Ruggiero, Dipartimento di Medicina Interna, Seconda Università di Napoli, Ospedale Gesù e Maria, Via Cotugno 1, 80135 Naples, Italy, Telephone: 39-81-566-6270, Fax: 39-81-566-6230, E-mail: giuseppe.ruggiero{at}unina2.it. Carlo Severini, Michela Menegon, Roberto Romi, and Giancarlo Majori, Laboratorio di Parassitologia, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy, Telephone: 39-6-4990-3378, Fax: 39-6-4938-7065, E-mail: majori{at}iss.it.

Reprint requests: Giancarlo Majori, Laboratorio di Parassitologia, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.




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