CASE REPORT: AN UNUSUAL LATE RELAPSE OF PLASMODIUM VIVAX MALARIA

EMANUELE DURANTE MANGONI Dipartimento di Medicina Interna, Seconda Università di Napoli, Naples, Italy; Laboratorio di Parassitologia, Istituto Superiore di Sanità, Rome, Italy

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CARLO SEVERINI Dipartimento di Medicina Interna, Seconda Università di Napoli, Naples, Italy; Laboratorio di Parassitologia, Istituto Superiore di Sanità, Rome, Italy

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MICHELA MENEGON Dipartimento di Medicina Interna, Seconda Università di Napoli, Naples, Italy; Laboratorio di Parassitologia, Istituto Superiore di Sanità, Rome, Italy

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ROBERTO ROMI Dipartimento di Medicina Interna, Seconda Università di Napoli, Naples, Italy; Laboratorio di Parassitologia, Istituto Superiore di Sanità, Rome, Italy

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GIUSEPPE RUGGIERO Dipartimento di Medicina Interna, Seconda Università di Napoli, Naples, Italy; Laboratorio di Parassitologia, Istituto Superiore di Sanità, Rome, Italy

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GIANCARLO MAJORI Dipartimento di Medicina Interna, Seconda Università di Napoli, Naples, Italy; Laboratorio di Parassitologia, Istituto Superiore di Sanità, Rome, Italy

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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.

Author Notes

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