title: Diagnostic and therapeutic pitfalls associated with primaquine-tolerant Plasmodium vivax.
abstract: We describe a U.S. Army Ranger returning from duty in Afghanistan and Iraq with life-threatening infection due to Plasmodium vivax. Morphological variants were observed in blood films prepared using samples collected by venipuncture. The patient's multiple relapses indicate infection with primaquine-tolerant P. vivax. Strategies for relapse prevention using primaquine are reviewed.
authors.affiliation: Veterans Affairs Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA, Los Angeles, USA.
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Spudick
authors.forename: Lynne S
authors.initials: LS
authors.lastname: Garcia
authors.forename: David M
authors.initials: DM
authors.lastname: Graham
authors.forename: David A
authors.initials: DA
authors.lastname: Haake
mesh_terms: D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D018890:Chemoprevention; D004351:Drug Resistance; D006801:Humans; D016780:Malaria, Vivax / Q000175:diagnosis* / Q000188:drug therapy* / Q000469:parasitology / Q000517:prevention & control; D008297:Male; D008889:Military Personnel; D018512:Parasitemia / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology / Q000517:prevention & control; D010966:Plasmodium vivax / Q000187:drug effects* / Q000302:isolation & purification; D011319:Primaquine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D055502:Secondary Prevention
chemical_list: D000962:Antimalarials; D011319:Primaquine