Volume 68, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


We observed an unusual case of 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 . parasites, but unclear morphologic characteristics did not allow discrimination between and . A nested polymerase chain reaction-based molecular analysis identified as the plasmodial species responsible. This case emphasizes the importance of taking into account the possibility of a very late initial relapse of malaria and the relevant issues in terms of infection control.


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  1. Mendis K, Sina BJ, Marchesini P, Carter R, 2001. The neglected burden of Plasmodium vivax malaria. Am J Trop Med Hyg 64 : 97–106.
  2. Carlini ME, White AC Jr, Atmar RL, 1999. Vivax malaria complicated by adult respiratory distress syndrome. Clin Infect Dis 28 : 1182–1183.
  3. Torres JR, Perez H, Postigo MM, Silva JR, 1997. Acute non-cardiogenic lung injury in benign tertian malaria. Lancet 350 : 31–32.
  4. Adak T, Sharma VP, Orlov VS, 1998. Studies on the Plasmodium vivax relapse pattern in Delhi, India. Am J Trop Med Hyg 59 : 175–179.
  5. Maslin J, Cuguillière A, Bonnet D, Martet G, 1997. Acces palustre; une rechute très tardive a Plasmodium vivax. Bull Soc Pathol Exot 90 : 25–26.
  6. Li J, Wirtz RA, McConkey GA, Sattabongkot J, Waters AP, Rogers MJ, McCutchan F, 1995. Plasmodium: genus-conserved primers for species identification and quantitation. Exp Parasitol 81 : 182–190.
  7. Izri MA, Lortolary O, Guillevin L, Rousset JJ, 1994. Accès palustre à Plasmodium vivax plus de cinq ans après un séjour a Meknès (Maroc). Bull Soc Pathol Exot 87 : 189.
  8. Cogswell FB, 1992. The hypnozoite and relapse in primate malaria. Clin Microbiol Rev 5 : 26–35.
  9. Craig AA, Kain KC, 1996. Molecular analysis of strains of Plasmodium vivax from paired primary and relapse infections. J Infect Dis 174 : 373–379.
  10. Kirchgatter K, del Portillo HA, 1998. Molecular analysis of Plasmodium vivax relapses using the MSP1 molecule as a genetic marker. J Infect Dis 177 : 511–515.
  11. Mungay M, Tegtmeier G, Chamberland M, Parise M, 2001. Transfusion-transmitted malaria in the United States from 1963 through 1999. N Engl J Med 344 : 1973–1978.
  12. Vu TT, Tran VB, Phan NT, Le TT, Luong VH, O’Brian E, Morris GE, 1995. Screening donor blood for malaria by polymerase chain reaction. Trans R Soc Trop Med Hyg 89 : 44–47.

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  • Received : 28 Jan 2002
  • Accepted : 02 Oct 2002

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