https://orcid.org/0000-0001-9223-7790
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Maria Luisa Aznar, Francesc Zarzuela, Elena Sulleiro, Begoña Treviño, Nuria Serre, Diana Pou, Fernando Salvador, Adrian Sanchez-Montalvá, Pau Bosch-Nicolau, Israel Molina, Ines Oliveira, Plasmodium malariae in a Spanish traveller returning from Colombia, Journal of Travel Medicine, Volume 26, Issue 4, 2019, taz022, https://doi.org/10.1093/jtm/taz022
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A 34-year-old Spanish traveller without previous medical history, presented to the outpatient clinic of Drassanes Tropical Medicine Unit at Hospital Vall d’Hebron (Barcelona) 35 days after her return from a 3-week holiday trip to Colombia in August 2018. She described a 3-week daily fever (maximum 39°C) that started 10 days after arrival with no other symptoms. Travel itinerary included the Caribbean Coast, Antioquia and Medellin. She did not consult for pre-travel advice and she did not take malaria chemoprophylaxis. She referred previous travels to Brazil in 2013 and Cabo Verde in 2017. At admission, medical examination was normal (temperature 36.5°C, blood pressure 114/72 mmHg, pulse 79 beats/min) and laboratory tests showed leucocytopenia, thrombocytopenia and mild transaminitis (Hb 12.3 g/dL, WBC 3.43 × 10E9/L, platelets 133 × 10E9/L, ESR 66 mm/h, AST 49 UI/L, ALT 62 UI/L). Examination of thick blood smear showed malaria parasites, being observed trophozoites of Plasmodium malariae (P. malariae) (<0.1% of erythrocytes infected) in the thin smear. A PfHRP2/PMA immunochromatographic test (BinaxNOW® Malaria Test) was negative and a nested PCR for Plasmodium species confirmed P. malariae infection. Chloroquine was initiated and fever remitted after 24 hours of treatment. Seventy-two hours later only gametocytes were observed in the thin blood smear. Control thick blood smear after 1 month of treatment was negative.
