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Case Reports
. 2024 Jun:143:107026.
doi: 10.1016/j.ijid.2024.107026. Epub 2024 Apr 5.

A severe case of Plasmodium falciparum malaria in a traveler returning from Kazakhstan, a malaria-free country

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Free article
Case Reports

A severe case of Plasmodium falciparum malaria in a traveler returning from Kazakhstan, a malaria-free country

Thirumalaisamy P Velavan et al. Int J Infect Dis. 2024 Jun.
Free article

Abstract

Following a 2-week trip to Kazakhstan, a 42-year-old woman presented at the emergency department in Germany with fever, headache, nausea, and neurological symptoms. An infection with Plasmodium falciparum was rapidly diagnosed. The patient was immediately treated with intravenous artesunate and transferred to an intensive care unit. The initial parasite density was as high as 30% infected erythrocytes with 845,880 parasites/µL. Since Kazakhstan was declared malaria-free in 2012, molecular testing for Plasmodium has been initiated to identify a possible origin. Genotyping of the msp-1 gene and microsatellite markers showed that the parasites are of African origin, with two different alleles indicating a polyclonal infection. After a hospitalization of 10 days, the patient was discharged in good health. Overall, our results emphasize that malaria must be on the list of differential diagnoses for patients with fever of unknown origin, even if they come from countries where malaria does not commonly occur.

Keywords: Germany; Kazakhstan; Malaria diagnosis; Plasmodium falciparum; Returning traveler; Severe malaria.

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Conflict of interest statement

Declarations of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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