Plasmodium falciparum: recrudescence of parasites in culture.

The basis of recrudescence, the reappearance of malaria parasites after chemotherapy or after failure of immune suppressions of the parasites, was studied in cultures of Plasmodium falciparum. When the cultured parasites were exposed eight times over a 4-day period to 5% D-sorbitol, which destroyed infected RBCs containing trophozoites or schizonts, they showed recrudescence several days after cessation of treatment. Pyrimethamine-sensitive parasites were cleared by 10(-6) M pyrimethamine; pyrimethamine-resistant parasites also were cleared by 10(-4) M pyrimethamine. Both groups of parasites underwent recrudescence in the same manner as those exposed to 5% D-sorbitol. These recrudescent parasites were found to be as susceptible to these treatments as were the parasites before treatment. Therefore, our results strongly suggest that a subpopulation of the parasites escapes the effect of drugs by a mechanism other than drug resistance.