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Case Reports
. 2005 Feb;43(2):978-81.
doi: 10.1128/JCM.43.2.978-981.2005.

Diagnostic and therapeutic pitfalls associated with primaquine-tolerant Plasmodium vivax

Jeanne M Spudick  1 , Lynne S Garcia, David M Graham, David A Haake
Affiliations
Case Reports

Diagnostic and therapeutic pitfalls associated with primaquine-tolerant Plasmodium vivax

Jeanne M Spudick et al. J Clin Microbiol. 2005 Feb.

Abstract

We describe a U.S. Army Ranger returning from duty in Afghanistan and Iraq with life-threatening infection due to Plasmodium vivax. Morphological variants were observed in blood films prepared using samples collected by venipuncture. The patient's multiple relapses indicate infection with primaquine-tolerant P. vivax. Strategies for relapse prevention using primaquine are reviewed.

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Figures

FIG. 1.
FIG. 1.
Time course of patient's P. vivax exposure, relapses, and treatment. See the text for details.
FIG. 2.
FIG. 2.
P. vivax trophozoites (A, B, C) and gametocytes (D, E, F). The images of P. vivax trophozoites demonstrate (A) the absence of stippling (Schüffner's dots), (B) a “band” form (mimic of P. malariae but showing an enlarged cell), and (C) an enlarged erythrocyte without stippling present (lack of stippling was due to delay in blood film preparation from anticoagulated blood). The images of P. vivax gametocytes include (D) a female macrogametocyte (note the compact pink nuclear chromatin), (E) a male macrogametocyte (note the more diffuse pink nuclear chromatin), and (F) male microgametes with a residual body (produced from the exflagellation of the male microgametocyte due to delay in blood film preparation from anticoagulated blood).
See this image and copyright information in PMC

References

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