title: A case of severe Plasmodium knowlesi in a splenectomized patient.
abstract: Plasmodium knowlesi, a zoonotic malaria, is now considered the fifth species of Plasmodium causing malaria in humans. With its 24-hour erythrocytic stage of development, it has raised concern regarding its high potential in replicating and leading to severe illness. Spleen is an important site for removal of parasitized red blood cells and generating immunity. We reported a case of knowlesi malaria in a non-immune, splenectomized patient. We observed the delay in parasite clearance, high parasitic counts, and severe illness at presentation. A thorough search through literature revealed several case reports on falciparum and vivax malaria in splenectomized patients. However, literature available for knowlesi malaria in splenectomized patient is limited. Further studies need to be carried out to clarify the role of spleen in host defense against human malaria especially P. knowlesi.
authors.affiliation: Department of Medicine, Hospital Enche' Besar Hajjah Khalsom, Jalan Kota Tinggi, 86000 Kluang, Johor Darul Takzim, Malaysia. Electronic address: coolrontin@gmail.com.
authors.forename: Yang Liang
authors.initials: YL
authors.lastname: Boo
authors.affiliation: Department of Medicine, Hospital Enche' Besar Hajjah Khalsom, Jalan Kota Tinggi, 86000 Kluang, Johor Darul Takzim, Malaysia. Electronic address: hongtaklim@gmail.com.
authors.forename: Hong Tak
authors.initials: HT
authors.lastname: Lim
authors.affiliation: Department of Medicine, Hospital Enche' Besar Hajjah Khalsom, Jalan Kota Tinggi, 86000 Kluang, Johor Darul Takzim, Malaysia. Electronic address: chinpw1964@yahoo.com.
authors.forename: Pek Woon
authors.initials: PW
authors.lastname: Chin
authors.affiliation: Department of Medicine, Hospital Sultanah Nora Ismail, 83000 Batu Pahat, Johor Darul Takzim, Malaysia. Electronic address: suatyee@hotmail.com.
authors.forename: Suat Yee
authors.initials: SY
authors.lastname: Lim
authors.affiliation: Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia; Malaysian Research Institute on Ageing Research, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia. Electronic address: hoofan@gmail.com.
authors.forename: Fan Kee
authors.initials: FK
authors.lastname: Hoo
mesh_terms: D000328:Adult; D004912:Erythrocytes / Q000469:parasitology / Q000648:ultrastructure; D006801:Humans; D008288:Malaria / Q000150:complications / Q000175:diagnosis / Q000276:immunology* / Q000469:parasitology*; D008297:Male; D059208:Parasite Load; D016790:Plasmodium knowlesi / Q000502:physiology*; D010966:Plasmodium vivax / Q000502:physiology; D013154:Spleen / Q000276:immunology / Q000469:parasitology; D013156:Splenectomy
keywords: Malaria; Plasmodium knowlesi; Splenectomy