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Imported tertian malaria resistant to primaquine.

Na DJ, Han JD, Cha DY, Song IK, Choi HW, Chung EA, Park CW, Choi JS - Korean J. Intern. Med. (1999)

Bottom Line: In Plasmodium vivax and Plasmodium ovale malaria, some of the liver stage parasites remain dormant.The activation of these dormant forms (called hypnozoite) can give rise to relapse weeks, months or years after the initial infection.Different strains of Plasmodium vivax vary in their sensitivity to primaquine and, recently, cases of relapse of Plasmodium vivax after this standard primaquine therapy were reported from various countries.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Sun General Hospital, Dae Jeon, Korea.

ABSTRACT
In Plasmodium vivax and Plasmodium ovale malaria, some of the liver stage parasites remain dormant. The activation of these dormant forms (called hypnozoite) can give rise to relapse weeks, months or years after the initial infection. To prevent relapses, a course of primaquine may be given as terminal prophylaxis to patients. Different strains of Plasmodium vivax vary in their sensitivity to primaquine and, recently, cases of relapse of Plasmodium vivax after this standard primaquine therapy were reported from various countries. We reported a case of primaquine resistant malaria which initially was thought to be relapsed caused by loss of terminal prophylaxis.

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Ring form of Plasmodium vivax (left) and a schizont of P. vivax (right) (Wright-Giemsa stain, x1000).
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f1-kjim-14-2-86-14: Ring form of Plasmodium vivax (left) and a schizont of P. vivax (right) (Wright-Giemsa stain, x1000).

Mentions: About three months after the first relapse, however, he revisited the hospital with fever, headache and chills. Physical examination showed no change, except that the spleen was felt 4cm below the costal margin. Peripheral blood examination showed variable forms of P.vivax (Fig. 1) with reduction in platelet count (97,000/mm3). He was given a diagnosis of primaquine resistant malaria. The patient was treated with chloroquine in the same dose as the in first attack. On the next day, he became afebrile and smear for malarial organisms had become negative. He subsequently received primaquine (22.5 mg daily for 21 days) without side effects from the drug. One month later, he was well and the spleen was no longer palpable. Symptoms have not relapsed during 5 months of observation.


Imported tertian malaria resistant to primaquine.

Na DJ, Han JD, Cha DY, Song IK, Choi HW, Chung EA, Park CW, Choi JS - Korean J. Intern. Med. (1999)

Ring form of Plasmodium vivax (left) and a schizont of P. vivax (right) (Wright-Giemsa stain, x1000).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4531922&req=5

f1-kjim-14-2-86-14: Ring form of Plasmodium vivax (left) and a schizont of P. vivax (right) (Wright-Giemsa stain, x1000).
Mentions: About three months after the first relapse, however, he revisited the hospital with fever, headache and chills. Physical examination showed no change, except that the spleen was felt 4cm below the costal margin. Peripheral blood examination showed variable forms of P.vivax (Fig. 1) with reduction in platelet count (97,000/mm3). He was given a diagnosis of primaquine resistant malaria. The patient was treated with chloroquine in the same dose as the in first attack. On the next day, he became afebrile and smear for malarial organisms had become negative. He subsequently received primaquine (22.5 mg daily for 21 days) without side effects from the drug. One month later, he was well and the spleen was no longer palpable. Symptoms have not relapsed during 5 months of observation.

Bottom Line: In Plasmodium vivax and Plasmodium ovale malaria, some of the liver stage parasites remain dormant.The activation of these dormant forms (called hypnozoite) can give rise to relapse weeks, months or years after the initial infection.Different strains of Plasmodium vivax vary in their sensitivity to primaquine and, recently, cases of relapse of Plasmodium vivax after this standard primaquine therapy were reported from various countries.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Sun General Hospital, Dae Jeon, Korea.

ABSTRACT
In Plasmodium vivax and Plasmodium ovale malaria, some of the liver stage parasites remain dormant. The activation of these dormant forms (called hypnozoite) can give rise to relapse weeks, months or years after the initial infection. To prevent relapses, a course of primaquine may be given as terminal prophylaxis to patients. Different strains of Plasmodium vivax vary in their sensitivity to primaquine and, recently, cases of relapse of Plasmodium vivax after this standard primaquine therapy were reported from various countries. We reported a case of primaquine resistant malaria which initially was thought to be relapsed caused by loss of terminal prophylaxis.

Show MeSH
Related in: MedlinePlus