Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea.
Ann Lab Med. 2012 May;32(3):229-33. doi: 10.3343/alm.2012.32.3.229. Epub 2012 Apr 18.
Malaria, the most common vector-borne parasite infection worldwide, results from infection by Plasmodium species. Approximately 80% of malaria cases are caused by P. vivax, which is broadly distributed from tropical to temperate regions; P. falciparum is the second most common infectious species. P. malariae and P. ovale are responsible for a relatively small proportion of malaria cases. Here, we report the case of a 23-yr-old Korean woman who acquired a P. malariae infection while visiting the Republic of Ghana in West Africa for business. She was diagnosed with P. malariae malaria on the basis of peripheral blood smear (PBS) and species-specific conventional and real-time PCR assays for 18S rRNA. She was treated with hydroxychloroquine, and the resulting PBS examination on day 2 suggested that negative conversion occurred. At her 1-month follow-up, however, both the PBS examination and molecular test for malaria demonstrated recurrent parasitemia. We started rescue therapy with mefloquine, and the patient recovered successfully. This is an important finding suggesting possible late recrudescence of a chloroquine-resistant P. malariae strain identified not only by its morphological features, but also by molecular tests.
疟疾是全球最常见的经蚊媒传播的寄生虫感染病，由疟原虫属物种感染引起。约 80%的疟疾病例由广泛分布于热带和温带地区的间日疟原虫引起，其次是恶性疟原虫。疟原虫和卵形疟原虫导致的疟疾病例相对较少。本研究报告了一例 23 岁韩国女性前往西非加纳共和国出差时感染间日疟原虫的病例。根据外周血涂片（PBS）和针对 18S rRNA 的种特异性常规和实时 PCR 检测，诊断为间日疟原虫疟疾。该患者接受了羟氯喹治疗，第 2 天的 PBS 检查提示转为阴性。然而，在 1 个月的随访时，PBS 检查和疟疾的分子检测均显示出现复发的寄生虫血症。我们开始使用甲氟喹进行挽救治疗，患者成功康复。这一重要发现提示可能存在耐氯喹的间日疟原虫株的迟发性复发，这不仅可以通过形态学特征，还可以通过分子检测来识别。
