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Apparent Relapse of Imported Plasmodium ovale Malaria in a Pregnant Woman

A 27 week pregnant woman who had lived in Bangkok, Thailand, for 18 months presented to her obstetrician with a 1-week history of intermittent fever and malaise. Medical history was significant for multiple episodes of malaria during her 10 years of employment in sub-Saharan Africa before her relocation to Thailand. The initial malaria smear was negative. She returned a week later with no resolution of her symptoms, at which time she was found to have Plasmodium ovale by microscopy and polymerase chain reaction. She had an excellent response to chloroquine, which she continued weekly until 36 weeks of gestation. She delivered a healthy term infant and received radical cure with primaquine after cessation of breastfeeding. This case shows challenging issues in detection and management of imported P. ovale malaria.

Received May 29, 2007. Accepted for publication July 15, 2007.

Disclaimer: The opinions or assertions contained herein are the personal views of the authors and are not to be construed as official or reflecting the views of the Armed Forces Research Institute of Medical Sciences, the United States Army Medical Department, the United States Department of the Army, or the United States Department of Defense.

^* Address correspondence to Rodney L. Coldren, USAMC-AFRIMS, APO, Bangkok 96546, Thailand. E-mail: Rodney.coldren{at}afrims.org

Authors’ addresses: Rodney Leland Coldren, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Rd., Bangkok, Thailand 10400, Telephone: 66–86–049–0094, Fax: 66–2–298–0518, E-mail: rodney.coldren{at}afrims.org. Krisada Jongsakul, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Rd., Bangkok, Thailand 10400, Telephone: 66–2–644–4888, Fax: 66–2–354–7873, E-mail: KrisidaJ{at}afrims.org. Sankiat Vayakornvichit, Samitivej Hospital, 133 Sukhumvit 49, Klongtan Nua Vadhana, Bangkok, Thailand 10110, Telephone: 66–2–392–0011, Fax: 66–2–391–1290, E-mail: sankiat{at}hotmail.com. Harald Noedl, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Rd., Bangkok, Thailand 10400, Telephone: 66–2–644–4888, Fax: 66–2–354–7873, E-mail: harald.noedl{at}meduniwien.ac.at. Mark M. Fukuda, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Rd., Bangkok, Thailand 10400, Telephone: 66–2–644–4888, Fax: 66–2–354–7873, E-mail: mark.fukuda{at}afrims.org.