Korean J Infect Dis.  2002 Dec;34(6):396-400.

A Case of Tertian Malaria which Recurred Three Times Despite Standard Chloroquine-primaquine Therapy

• Lee HY
• Han JY
• Lee KD
• Park WB
• Kim SH
• Kang CI
• Moon JJ
• Oh MD
• Choe KW

Abstract

Plasmodium vivax malaria, which used to be endemic in the past, re-emerged in 1993 and the number of cases has increased annually. Though there has been no proven endemic drug-resistant malaria case reported, widespread use of anti-malarial chemoprophylaxis for the military personnel could cause emergence of resistance. We herein report a case of tertian malaria, which recurred three times despite the standard chloroquine-primaquine therapy. The patient is 40-year-old male, lives in Dongducheon city, Gyeonggy province, and has never been abroad. He visited hospital in September 2000, because of fever. His blood smear revealed ring forms and trophozoites of P. vivax. He took hydroxychloroquine for 3 days and primaquine for 14 days. His symptoms disappeared then. After 7 months he got fever for 2 days and his blood smear revealed schizonts of P. vivax. He took the same medicines and got well next day. Fever recurred 4 month later, and trophozoites were observed on the blood smear. Hydroxychloroquine and primaquine were prescribed in the same way and fever disappeared. Forty three days later, he had fever and positive blood smear of P. vivax trophozoite. Fever disappeared on the day drug was administered and no malaria was detected in follow up smear of 7 and 14 days. He was free of fever in follow up at 3 months later.

Keyword

Plasmodium vivax; Chloroquine; Primaquine; Relapse

MeSH Terms

Adult
Chemoprevention
Chloroquine
Fever
Follow-Up Studies
Gyeonggi-do
Humans
Hydroxychloroquine
Malaria*
Malaria, Vivax
Male
Military Personnel
Plasmodium vivax
Primaquine
Recurrence
Schizonts
Trophozoites
Chloroquine
Hydroxychloroquine
Primaquine