Clinical features of Plasmodium vivax malaria

Song, Hun Ho; O, Soon Ok; Kim, Su Ho; Moon, Sang Ho; Kim, Jin Bong; Yoon, Jong Woo; Koo, Ja Ryong; Hong, Kyung Sun; Lee, Myung Goo; Kim, Dong Joon; Shin, Dong Hoon; Kang, Sung Ha; Choi, Moon Gi; Lee, Kwang Hack

Abstract

BACKGROUND: Since Plasmodium vivax malaria reemerged in Korea in 1993, a number of patients with malaria have been reported. We analyzed the cases with malaria who lived in Chuncheon and neighboring communities to find out clinical manifestations, laboratory findings and the differences in clinical findings compared to previous studies.
METHODS
We reviewed the clinical records of the cases who were confirmed as malaria by peripheral blood smear in Chuncheon Sacred Heart Hospital from July, 1998 to Octorber, 2001.
RESULTS
Forty-four cases were included. All cases were Plasmodium vivax with high fever, but tertian fever developed only in 15 patients (35.7%). A number of cases showed various symptoms including headache, abdominal pain, nausea, vomiting. Of the all cases, 41 cases (93.2%) developed malaria between June and September. Thrombocytopenia was prominent finding which was noted in 75% of the cases at diagnosis, and recovered during or after treatment. Other laboratory abnormalities such as anemia, elevated transaminases, coagulopathies, and elevated LDH level were also noted. Five patients were performed CSF studies, one patient showed pleocytosis in CSF.
CONCLUSION
We observed that only 15 patients (35.7%) had tertian fever, the others had variable fever patterns. Thrombocytopenia was the prominent findings. Therefore we suggest that malaria should be included in the differential diagnosis of febrile diseases which developed from June to September regardless of the fever patterns.