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Article in Japanese

A Guinean 4-year-old girl with mixed infection with Plasmodium falciparum and Plasmodium ovale

Saki KINOSHITA1), Yuta AIZAWA2), Kotaro ARAKI2), Mai ARAI3), Yuho HORIKOSHI2)

Malaria is a mosquito-borne infection and endemic mainly in the tropics and sub-tropics of Africa, Asia and South America. Severe or fatal diseases predominantly developed by Plasmodium falciparum, which should be treated promptly with antimalarial agents. Therefore, differentiating malaria diagnosis is essential in febrile travelers returning from endemic areas. This study, hereby, reports a rare pediatric case of mixed P. falciparum and Plasmodium ovale infections. A previously healthy- 4-year-old girl was seen by a local physician for fever, vomiting and diarrhea lasting for 16 days. After recognizing her travel history of an endemic area, she was suspected of having malaria and referred for further management. Her Guinean parents moved to Japan 6 years previously, and the patient was born and raised in Japan. She had stayed in Guinea for two months during two months and twenty days prior to hospitalization. She had a history of malaria, which was treated in Guinea. Diagnosis of P. falciparum was made by the rapid antigen test and blood smear with Giemsa staining. She was treated with oral atovaquone-proguanil. As a rapid antigen test also was positive for non-P. falciparum, a mixed infection with P. ovale was confirmed subsequently by smear and polymerase chain reaction. Treatment with primaquine was added for hypnozoite of P. ovale. In general, malaria cases present with non-specific symptoms, therefore, taking travel history to endemic areas is critical for diagnosis. Mixed infections should be considered, as additional treatment is required for hypnozoite.

1) Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center
2) Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center
3) Department of Pediatrics, Fussa Hospital

Key words Plasmodium falciparum, Plasmodium ovale, mixed infection, travel history, infant
Received January 22, 2018
Accepted April 18, 2018

30 (2):139─144,2018