Volume 92, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



A 58-year-old Thai man was infected with in Chantaburi Province, eastern Thailand. In addition to pyrexia, the patient developed hypotension, renal failure, jaundice, and severe thrombocytopenia. The parasitemia at the time of admission was 16.67% or ∼503,400 parasites/μL. With artesunate treatment and supportive care, the patient recovered uneventfully. The occurrence of complicated knowlesi malaria in a low-endemic area underscores the risk of high morbidity from this simian malaria.


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  1. Coatney GR, Collins WE, Warren M, Contacos PG, , 2003. The Primate Malarias. [original book published 1971] [CD-ROM]. Version 1.0. Atlanta, GA: Centers for Disease Control and Prevention. [Google Scholar]
  2. Daneshvar C, Davis TM, Cox-Singh J, Rafa'ee MZ, Zakaria SK, Divis PC, Singh B, , 2009. Clinical and laboratory features of human Plasmodium knowlesi infection. Clin Infect Dis 49: 852860.[Crossref] [Google Scholar]
  3. William T, Menon J, Rajahram G, Chan L, Ma G, Donaldson S, Khoo S, Frederick C, Jelip J, Anstey NM, Yeo TW, , 2011. Severe Plasmodium knowlesi malaria in a tertiary care hospital, Sabah, Malaysia. Emerg Infect Dis 17: 12481255.[Crossref] [Google Scholar]
  4. Putaporntip C, Hongsrimuang T, Seethamchai S, Kobasa T, Limkittikul K, Cui L, Jongwutiwes S, , 2009. Differential prevalence of Plasmodium infections and cryptic Plasmodium knowlesi malaria in humans in Thailand. J Infect Dis 199: 11431150.[Crossref] [Google Scholar]
  5. Jongwutiwes S, Buppan P, Kosuvin R, Seethamchai S, Pattanawong U, Sirichaisinthop J, Putaporntip C, , 2011. Plasmodium knowlesi malaria in humans and macaques, Thailand. Emerg Infect Dis 17: 17991806.[Crossref] [Google Scholar]
  6. Grigg MJ, William T, Dhanaraj P, Menon J, Barber BE, von Seidlein L, Rajahram G, Price RN, Anstey NM, Yeo TW, , 2014. A study protocol for a randomized open-label clinical trial of artesunate-mefloquine versus chloroquine in patients with non-severe Plasmodium knowlesi malaria in Sabah, Malaysia (ACT KNOW trial). BMJ Open 4: e006005.[Crossref] [Google Scholar]
  7. Sitprija V, Indraprasit S, Pochanugool C, Benyajati C, Piyaratn P, , 1967. Renal failure in malaria. Lancet 7483: 185188.[Crossref] [Google Scholar]
  8. Sitprija V, Vongsthongsri M, Poshyachinda V, Arthachinta S, , 1977. Renal failure in malaria: a pathophysiologic study. Nephron 18: 277287.[Crossref] [Google Scholar]
  9. Boonpucknavig V, Sitprija V, , 1979. Renal disease in acute Plasmodium falciparum infection in man. Kidney Int 16: 4452.[Crossref] [Google Scholar]
  10. Hanson JP, Lam SW, Mohanty S, Alam S, Pattnaik R, Mahanta KC, Hasan MU, Charunwatthana P, Mishra SK, Day NP, White NJ, Dondorp AM, , 2013. Fluid resuscitation of adults with severe falciparum malaria: effects on acid-base status, renal function, and extravascular lung water. Crit Care Med 41: 972981.[Crossref] [Google Scholar]
  11. Hanson J, Lam SW, Mahanta KC, Pattnaik R, Alam S, Mohanty S, Hasan MU, Hossain A, Charunwatthana P, Chotivanich K, Maude RJ, Kingston H, Day NP, Mishra S, White NJ, Dondorp AM, , 2012. Relative contributions of macrovascular and microvascular dysfunction to disease severity in falciparum malaria. J Infect Dis 206: 571579.[Crossref] [Google Scholar]
  12. Perkins DJ, Were T, Davenport GC, Kempaiah P, Hittner JB, Ong'echa JM, , 2011. Severe malarial anemia: innate immunity and pathogenesis. Int J Biol Sci 7: 14271442.[Crossref] [Google Scholar]
  13. World Health Organization, 1990. Severe and complicated malaria. Trans R Soc Trop Med Hyg 84 (Suppl 2): 165. [Google Scholar]
  14. Sadun EH, Williams JS, Martin LK, , 1966. Serum biochemical changes in malarial infections in men, chimpanzees and mice. Mil Med 131 (Suppl): 10941106. [Google Scholar]
  15. Lacerda MV, Mourão MP, Coelho HC, Santos JB, , 2011. Thrombocytopenia in malaria: who cares? Mem Inst Oswaldo Cruz 106 (Suppl 1): 5263.[Crossref] [Google Scholar]
  16. Muniz-Junqueira MI, dos Santos-Neto LL, Tosta CE, , 2001. Influence of tumor necrosis factor-alpha on the ability of monocytes and lymphocytes to destroy intraerythrocytic Plasmodium falciparum in vitro . Cell Immunol 208: 7379.[Crossref] [Google Scholar]
  17. Mohan K, Dubey ML, Ganguly NK, Mahajan RC, , 1995. Plasmodium falciparum: role of activated blood monocytes in erythrocyte membrane damage and red cell loss during malaria. Exp Parasitol 80: 5463.[Crossref] [Google Scholar]
  18. Barber BE, William T, Grigg MJ, Menon J, Auburn S, Marfurt J, Anstey NM, Yeo TW, , 2013. A prospective comparative study of knowlesi, falciparum, and vivax malaria in Sabah, Malaysia: high proportion with severe disease from Plasmodium knowlesi and Plasmodium vivax but no mortality with early referral and artesunate therapy. Clin Infect Dis 56: 383397.[Crossref] [Google Scholar]
  19. Fatih FA, Staines HM, Siner A, Ahmed MA, Woon LC, Pasini EM, Kocken CH, Singh B, Cox-Singh J, Krishna S, , 2013. Susceptibility of human Plasmodium knowlesi infections to anti-malarials. Malar J 12: 425.[Crossref] [Google Scholar]
  20. World Health Organization, 2014. Severe malaria. Trop Med Int Health 19 (Suppl 1): 7131. [Google Scholar]
  21. Orth H, Jensen BO, Holtfreter MC, Kocheril SJ, Mallach S, MacKenzie C, Müller-Stöver I, Henrich B, Imwong M, White NJ, Häussinger D, Richter J, , 2013. Plasmodium knowlesi infection imported to Germany, January 2013. Euro Surveill 18: 20603.[Crossref] [Google Scholar]

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  • Received : 01 Oct 2014
  • Accepted : 18 Nov 2014
  • Published online : 04 Mar 2015

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