title: Case report: An unusual late relapse of Plasmodium vivax malaria.
abstract: 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.
authors.affiliation: Dipartimento di Medicina Interna, Seconda Università di Napoli, Ospedale Gesù e Maria, Naples, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Durante Mangoni
authors.forename: Carlo
authors.initials: C
authors.lastname: Severini
authors.forename: Michela
authors.initials: M
authors.lastname: Menegon
authors.forename: Roberto
authors.initials: R
authors.lastname: Romi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ruggiero
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Majori
mesh_terms: D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage; D002738:Chloroquine / Q000008:administration & dosage; D016054:DNA, Protozoan / Q000235:genetics; D003937:Diagnosis, Differential; D004334:Drug Administration Schedule; D006801:Humans; D016780:Malaria, Vivax / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010966:Plasmodium vivax / Q000235:genetics / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D011319:Primaquine / Q000008:administration & dosage; D012008:Recurrence
chemical_list: D000962:Antimalarials; D016054:DNA, Protozoan; D002738:Chloroquine; D011319:Primaquine