title: Plasmodium falciparum malaria recrudescence occurring 2.5 years after leaving an endemic country.
abstract: Malaria tropica is almost exclusively diagnosed within two months after returning from an endemic country. We present here a male patient with severe P. falciparum malaria diagnosed 2.5 years after returning from Burkina-Faso. We speculate that our patient was chronically infected with PF malaria for more than 2 years, with an undetectable parasite index and without symptoms. Because of waning immunity clinically overt PF malaria was able to develop. This case illustrates the importance of malaria suspicion as a cause of illness in immigrants from malaria-endemic countries. Even when these immigrants did not travel for a long time, malaria should be considered in patients with typical symptoms.
authors.affiliation: Department of Internal Medicine, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands.
authors.forename: M A H
authors.initials: MA
authors.lastname: Berrevoets
authors.forename: T
authors.initials: T
authors.lastname: Sprong
authors.forename: J F
authors.initials: JF
authors.lastname: Meis
authors.forename: A S M
authors.initials: AS
authors.lastname: Dofferhoff
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use; D037621:Artemisinins / Q000627:therapeutic use; D053626:Atovaquone / Q000627:therapeutic use; D002050:Burkina Faso; D018450:Disease Progression; D004338:Drug Combinations; D019353:Endemic Diseases; D006801:Humans; D007783:Lactones / Q000627:therapeutic use; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010963:Plasmodium falciparum / Q000302:isolation & purification*; D002727:Proguanil / Q000627:therapeutic use; D013997:Time Factors; D014195:Travel
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D004338:Drug Combinations; D007783:Lactones; C109496:atovaquone, proguanil drug combination; D002727:Proguanil; C075875:artemisin; D053626:Atovaquone