Molecular evidence for relapse of an imported Plasmodium ovale wallikeri infection.

Abstract:

BACKGROUND:Malaria caused by Plasmodium ovale spp. has been neglected by and large from research and has received only little scientific attention during the past decades. Ovale malaria is considered to feature relapses by liver hypnozoites although scientific evidence for this paradigm is scarce. CASE PRESENTATION:Here, the case of a 16-year-old male, who presented with fevers to the outpatient department in Vienna, Austria, after travelling to Uganda and Papua New Guinea is described. Infection with Plasmodium malariae was diagnosed by microscopy and the patient was treated accordingly with a full course of supervised artemether-lumefantrine. He was discharged in good clinical condition with a negative blood smear. One month after initial diagnosis, he returned complaining of fever. Thick blood smear was positive again for malaria parasites, which were confirmed as P. ovale wallikeri by PCR. Retrospective analysis revealed the identical Plasmodium spp. in the initial blood samples. Molecular analysis of various gene loci (nuclear porbp2, 18S rRNA and potra genes) gave identical results providing further evidence for relapse by an identical parasite genotype. Consecutively, the patient was retreated with artemether-lumefantrine and received a regimen of primaquine according to WHO guidelines. CONCLUSION:Conclusive evidence for relapses with P. ovale spp. is rare. The presented case provides convincing confirmation for the relapse paradigm based on re-appearing parasitaemia following supervised treatment in a non-endemic region with a parasite strain of identical genotype.

journal_name

Malar J

journal_title

Malaria journal

authors

Veletzky L,Groger M,Lagler H,Walochnik J,Auer H,Fuehrer HP,Ramharter M

doi

10.1186/s12936-018-2226-4

subject

Has Abstract

pub_date

2018-02-09 00:00:00

pages

78

issue

1

issn

1475-2875

pii

10.1186/s12936-018-2226-4

journal_volume

17

pub_type

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