Lab Med Online.  2019 Jul;9(3):194-196. 10.3343/lmo.2019.9.3.194.

A Case of False-negative Malaria Rapid Diagnostic Test Induced by Treatment with Doxycycline

• Lim JH
• Baek EJ

• KMID: 2450848
• DOI: http://doi.org/10.3343/lmo.2019.9.3.194

Abstract

Rapid diagnostic tests (RDTs) for malaria using antibodies against pan-Plasmodium antigen lactate dehydrogenase (pLDH) are commonly used for malaria diagnosis. The level of malaria parasitemia determined by peripheral blood smears (PBS) correlates with the pLDH concentration in most cases. We report a case of malaria recurrence associated with false-negative RDT results. A 22-year-old male patient was admitted to the Armed Forces Capital Hospital with fever and chills, and was diagnosed with malaria infection. Four days after antimalarial treatment, these symptoms recurred. After admitting to our hospital, doxycycline was administered for 4 days. Even after administration of doxycycline, the malaria parasites in blood smears remained positive, but RDT showed negative results. Therefore, for patients receiving doxycycline, serial blood smear testing should be performed to exclude false-negative malaria RDT results.

Keyword

Malaria; Rapid diagnostic test; Peripheral blood smear; Doxycycline; Lactate dehydrogenase

MeSH Terms

Antibodies
Arm
Chills
Diagnosis
Diagnostic Tests, Routine*
Doxycycline*
Fever
Humans
L-Lactate Dehydrogenase
Malaria*
Male
Parasitemia
Parasites
Recurrence
Young Adult
Antibodies
Doxycycline
L-Lactate Dehydrogenase

Figure

• 

  Fig. 1 Flow chart of diagnostic tests and treatments. Abbreviations: HD, hospital day of admission; RDT, rapid diagnostic test; PBS, peripheral blood smear; Neg, negative; Pos, positive.

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