The challenge of diagnosing Plasmodium ovale malaria in travellers: report of six clustered cases in french soldiers returning from West Africa

Malaria Journal

Case Report

Alexandre Mendibil¹  Franck de Laval²  Xavier Deparis²  Vincent Pommier de Santi²  Christophe Rapp³  Manuela Oliver⁴  Fabrice Simon⁴ 

[1] Cabinet Médical, 8RPIMa, Castres, France;Department of Epidemiology and Public Health, Tropical Medicine Institute of the Military Health Service, Marseille, France;Department of Infectious Diseases and Tropical Medicine, Begin Military Teaching Hospital, Saint-Mandé, France;Department of Infectious Diseases and Tropical Medicine, Laveran Military Teaching Hospital, Marseille, France;

关键词: Malaria;    Doxycycline;    Chloroquine;    Rapid Diagnostic Test;    Ivory Coast;   

DOI  :  10.1186/1475-2875-9-358

 received in 2010-06-21, accepted in 2010-12-10,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundPlasmodium ovale is responsible for 5% of imported malaria in French travellers. The clinical and biological features of six clustered cases of P. ovale malaria in an army unit of 62 French soldiers returning from the Ivory Coast are reported.Case reportAll patients were symptomatic and developed symptoms on average 50 days after their return and 20 days after the end of chemoprophylaxis (doxycycline). Clinical features included fever (6/6), mostly tertian (4/6), aches (6/6), nausea (3/6), abdominal pain (2/6), diarrhoea (2/6), or cough (2/6). Thrombocytopaenia was lower than 100,000/mm3 in half the cases only, and the haemoglobin count was normal for all patients. The diagnosis was made after at least three thick and thin blood smear searches. Parasitaemia was always lower than 0.5%. All rapid diagnostic tests were negative for HRP2 and pLDH antigens.DiscussionPlasmodium ovale malaria is currently a problem to diagnose in travellers, notably in French soldiers returning from the Ivory Coast. Early attempts at diagnosis are difficult due to the lack of specific clinical features, the rarity of biological changes and the poor sensitivity of diagnostic tools to detect low parasitaemia. Thus, the diagnosis is commonly delayed or missed. Physicians should be aware of this diagnostic challenge to avoid relapses and provide prompt and adequate treatment with chloroquine and radical cure with primaquine.

【 授权许可】

Unknown   
© de Laval et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.