title: Late relapse of imported Plasmodium ovale malaria: a case report.
abstract: We report the first case of an imported Plasmodium ovale relapse in a Tunisian man who developed malaria three years after leaving sub- Saharan Africa. A 29-year-old Tunisian man consulted in September 2011 because of a fever, myalgia, and headache that had begun eight days earlier and persisted despite treatment with oral antibiotics. On questioning, the patient stated that he had resided three years ago for six months in Ivory Coast, where he acquired malaria. He was treated with artemether-lumefantrine. The patient said he had no recent travel to any other malaria-endemic area and had not received a blood transfusion. A first microscopy of peripheral blood smears was negative for malaria parasites. The diagnosis was established 17 days after onset of symptoms. A repeat microscopic examination of blood smears confirmed the presence of Plasmodium ovale with a parasitemia lower than 0.1%. The patient was treated with artemether lumefantrine, followed by primaquine. This case emphasizes the possibility of relapse of some plasmodial species. It highlights the importance of repeating microscopic examination of blood when the diagnosis of malaria is suspected.
authors.forename: Emna
authors.initials: E
authors.lastname: Siala
authors.forename: Mondher
authors.initials: M
authors.lastname: Gastli
authors.forename: Rym
authors.initials: R
authors.lastname: Essid
authors.forename: Sana
authors.initials: S
authors.lastname: Jemal
authors.forename: Rym
authors.initials: R
authors.lastname: Ben Abdallah
authors.forename: Imène
authors.initials: I
authors.lastname: Ben Abda
authors.forename: Karim
authors.initials: K
authors.lastname: Aoun
authors.forename: Aida
authors.initials: A
authors.lastname: Bouratbine
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins / Q000627:therapeutic use; D007560:Cote d'Ivoire; D004338:Drug Combinations; D004983:Ethanolamines / Q000627:therapeutic use; D005449:Fluorenes / Q000627:therapeutic use; D006801:Humans; D008288:Malaria / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology*; D008297:Male; D041122:Plasmodium ovale / Q000187:drug effects / Q000302:isolation & purification*; D011319:Primaquine / Q000627:therapeutic use; D012008:Recurrence; D014195:Travel; D016896:Treatment Outcome; D014416:Tunisia
chemical_list: D000962:Antimalarials; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins; D004338:Drug Combinations; D004983:Ethanolamines; D005449:Fluorenes; D011319:Primaquine