Plasmodium vivax malaria after autologous bone marrow transplantation: an unusual complication.
We report the case of unusually early infection by Plasmodium vivax after autologous bone marrow transplantation in a 20-year-old female from Bangladesh affected by acute myelogenous leukemia in first complete remission (CR) who underwent autologous bone marrow transplantation in our center. During the aplastic phase she became febrile; broad spectrum antibiotics and antifungal therapy were without effect. Blood smears were examined and Plasmodium vivax was detected despite a very low number of red cells infected. Cloroquine therapy for 3 days was given followed by primaquine for 2 weeks in order to avoid possible cloroquine resistance. Fever disappeared within 48 h from initial treatment and the patient was discharged having completely recovered at day +30. Primary malaria infection in non-endemic areas is a very rare event. In this particular case, after excluding primary infection or blood transfusion-mediated infection, malaria was attributed to a recrudescence of a primary unidentified infection.
Istituto di Semeiotica Medica, Università Cattolica Sacro Cuore, Rome, Italy.
P
P
Salutari
S
S
Sica
P
P
Chiusolo
G
G
Micciulli
P
P
Plaisant
A
A
Nacci
A
A
Antinori
G
G
Leone
D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002738:Chloroquine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D015479:Leukemia, Myelomonocytic, Acute / Q000628:therapy; D016780:Malaria, Vivax / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D009894:Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014182:Transplantation, Autologous
D000962:Antimalarials; D002738:Chloroquine