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Published in: Malaria Journal 1/2019

Open Access 01-12-2019 | Chloroquin | Case report

A case of Plasmodium malariae recurrence: recrudescence or reinfection?

Authors: Romualdo Grande, Spinello Antinori, Luca Meroni, Michela Menegon, Carlo Severini

Published in: Malaria Journal | Issue 1/2019

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Abstract

Background

Plasmodium malariae is the most neglected of the six human malaria species and it is still unknown which is the mechanism underlying the long latency of this Plasmodium.

Case presentation

A case of PCR-confirmed P. malariae recurrence in a 52-year old Italian man was observed 5 months after a primary attack. In the interval between the two observed episodes of malaria the patient denied any further stay in endemic areas except for a visit to Libya, a country considered malaria-free. Genomic DNA of the P. malariae strain using five microsatellites (PM2, PM9, PM11, PM25, PM34) and the antigen marker of circumsporozoite (csp) was amplified and sequenced. Analysis of polymorphisms of the P. malariae csp central repeat region showed differences between the strains responsible of the first and second episode of malaria. A difference in the allele size was also observed for the sequence analysis of PM2 microsatellites.

Conclusions

Plasmodium malariae is a challenging human malaria parasite and even with the use of molecular techniques the pathogenesis of recurrent episodes cannot be precisely explained.
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Literature
2.
go back to reference Golgi C. Malarial infection. Arch Sci Med. 1886;10:109–35 (in Italian). Golgi C. Malarial infection. Arch Sci Med. 1886;10:109–35 (in Italian).
3.
go back to reference Garnham PCC. The myth of quartan malaria (Haemamoeba laverani var. quartana Labbé, 1894). Trans R Soc Trop Med Hyg. 1981;75:616–7.PubMedCrossRef Garnham PCC. The myth of quartan malaria (Haemamoeba laverani var. quartana Labbé, 1894). Trans R Soc Trop Med Hyg. 1981;75:616–7.PubMedCrossRef
4.
go back to reference Betson M, Sousa-Figueiredo JC, Atuhaire A, Arinaitwe M, Adriko M, Mwesigwa G, et al. Detection of persistent Plasmodium spp. infections in Ugandan children after artemether–lumefantrine treatment. Parasitology. 2014;141:1880–90.PubMedPubMedCentralCrossRef Betson M, Sousa-Figueiredo JC, Atuhaire A, Arinaitwe M, Adriko M, Mwesigwa G, et al. Detection of persistent Plasmodium spp. infections in Ugandan children after artemether–lumefantrine treatment. Parasitology. 2014;141:1880–90.PubMedPubMedCentralCrossRef
5.
go back to reference Guazzi M, Grazi S. Considerations on a case of quartan malaria recurring after 53 years of latency. Riv Malariol. 1963;42:55–9 (in Italian).PubMed Guazzi M, Grazi S. Considerations on a case of quartan malaria recurring after 53 years of latency. Riv Malariol. 1963;42:55–9 (in Italian).PubMed
6.
go back to reference Vinetz JM, McCutchan TH, Kaslow DC. Plasmodium malariae infection in an asymptomatic 74-year-old Greek woman with splenomegaly. N Engl J Med. 1998;338:367–71.PubMedCrossRef Vinetz JM, McCutchan TH, Kaslow DC. Plasmodium malariae infection in an asymptomatic 74-year-old Greek woman with splenomegaly. N Engl J Med. 1998;338:367–71.PubMedCrossRef
7.
go back to reference Chadee DD, Tilluckharry CC, Maharai P, Sinanan C. Reactivation of Plasmodium malariae infection in a Trinidadian man after neurosurgery. N Engl J Med. 2000;342:1924.PubMedCrossRef Chadee DD, Tilluckharry CC, Maharai P, Sinanan C. Reactivation of Plasmodium malariae infection in a Trinidadian man after neurosurgery. N Engl J Med. 2000;342:1924.PubMedCrossRef
8.
go back to reference Garnham PCC. The continuing mystery of relapses in malaria. Protozool Abstr. 1977;1:1–12. Garnham PCC. The continuing mystery of relapses in malaria. Protozool Abstr. 1977;1:1–12.
9.
go back to reference Corradetti A, Verolini F. Relapses due to Plasmodium malariae and P. cynomolgi in infections produced by blood inoculations. Rend Ist Sup Sanit. 1951;14:271–81 (in Italian).PubMed Corradetti A, Verolini F. Relapses due to Plasmodium malariae and P. cynomolgi in infections produced by blood inoculations. Rend Ist Sup Sanit. 1951;14:271–81 (in Italian).PubMed
10.
go back to reference Bignami A. Sulla patogenesi delle recidive nelle febbri malariche. Atti Soc Studi Malaria. 1910;11:731–46. Bignami A. Sulla patogenesi delle recidive nelle febbri malariche. Atti Soc Studi Malaria. 1910;11:731–46.
11.
go back to reference Bruce MC, Macheso A, Galinski MR, Barnwell JW. Characterization and application of multiple genetic markers for Plasmodium malariae. Parasitology. 2007;134:637–50.PubMedCrossRef Bruce MC, Macheso A, Galinski MR, Barnwell JW. Characterization and application of multiple genetic markers for Plasmodium malariae. Parasitology. 2007;134:637–50.PubMedCrossRef
12.
go back to reference Shute PG. Relapse of quartan fever after 12 and 21 years. Lancet. 1944;2:146.CrossRef Shute PG. Relapse of quartan fever after 12 and 21 years. Lancet. 1944;2:146.CrossRef
13.
go back to reference Spitler DK. Malaria relapse. Report of a case thirty-six years after original infection. N Engl J Med. 1948;238:839.PubMedCrossRef Spitler DK. Malaria relapse. Report of a case thirty-six years after original infection. N Engl J Med. 1948;238:839.PubMedCrossRef
14.
go back to reference Lentini D, Tecce T. R Long-term recurrence of quartan malaria. Riv Malariol. 1955;34:259–65 (in Italian).PubMed Lentini D, Tecce T. R Long-term recurrence of quartan malaria. Riv Malariol. 1955;34:259–65 (in Italian).PubMed
15.
go back to reference Creyx M, Leng-Levy J, Laborie G. Le problème des reviviscences tardives des paludismes humains. Presse Med. 1955;63:877–8.PubMed Creyx M, Leng-Levy J, Laborie G. Le problème des reviviscences tardives des paludismes humains. Presse Med. 1955;63:877–8.PubMed
16.
go back to reference Duggan AJ, Shute PG. Quartan malaria relapsing after thirteen years. J Trop Med Hyg. 1961;64:20–1.PubMed Duggan AJ, Shute PG. Quartan malaria relapsing after thirteen years. J Trop Med Hyg. 1961;64:20–1.PubMed
17.
go back to reference Tsuchida H, Yamaguchi K, Yamamoto S, Ebisawa I. Quartan malaria following splenectomy 36 years after infection. Am J Trop Med Hyg. 1982;31:163–5.PubMedCrossRef Tsuchida H, Yamaguchi K, Yamamoto S, Ebisawa I. Quartan malaria following splenectomy 36 years after infection. Am J Trop Med Hyg. 1982;31:163–5.PubMedCrossRef
18.
go back to reference Hess FJ, Kilian HAD, Nothdurft HD, Loscher T. Problems in the therapy of mixed malarial infections: a case of infection with Plasmodium falciparum and P. malariae treated with mefloquine. Trans R Soc Trop Med Hyg. 1993;87:688.PubMedCrossRef Hess FJ, Kilian HAD, Nothdurft HD, Loscher T. Problems in the therapy of mixed malarial infections: a case of infection with Plasmodium falciparum and P. malariae treated with mefloquine. Trans R Soc Trop Med Hyg. 1993;87:688.PubMedCrossRef
19.
go back to reference Skoutelis A, Symeonidis A, Vassalou E, Bassaris H. Drug-induced acute malaria. Scand J Infect Dis. 2000;32:333.PubMedCrossRef Skoutelis A, Symeonidis A, Vassalou E, Bassaris H. Drug-induced acute malaria. Scand J Infect Dis. 2000;32:333.PubMedCrossRef
20.
go back to reference Morovic M, Poljak I, Miletic B, Troselj-Vukic B, Seili-Bekafigo I, Milotic I. Late symptomatic Plasmodium malariae relapse in the territory of the former Yugoslavia. J Travel Med. 2003;10:301–2.PubMedCrossRef Morovic M, Poljak I, Miletic B, Troselj-Vukic B, Seili-Bekafigo I, Milotic I. Late symptomatic Plasmodium malariae relapse in the territory of the former Yugoslavia. J Travel Med. 2003;10:301–2.PubMedCrossRef
21.
go back to reference Chim CS, Wong SSY, Lam CCK, Chan KW. Concurrent hyperreactive malarial splenomegali and quartan malaria nephropathy-Plasmodium malariae revisited. Haematologica. 2004;89:e74–5. Chim CS, Wong SSY, Lam CCK, Chan KW. Concurrent hyperreactive malarial splenomegali and quartan malaria nephropathy-Plasmodium malariae revisited. Haematologica. 2004;89:e74–5.
22.
go back to reference Muller-Stover I, Verweij JJ, Hoppenheit B, Gubels K, Haussinger D, Richter J. Plasmodium malariae infection in spite of previous anti-malarial medication. Parasitol Res. 2008;102:547–50.PubMedCrossRef Muller-Stover I, Verweij JJ, Hoppenheit B, Gubels K, Haussinger D, Richter J. Plasmodium malariae infection in spite of previous anti-malarial medication. Parasitol Res. 2008;102:547–50.PubMedCrossRef
23.
go back to reference Smith A, Denholm J, Shortt J, Spelman D. Plasmodium species co-infection as a cause of treatment failure. Travel Med Infect Dis. 2011;9:306–9.PubMedCrossRef Smith A, Denholm J, Shortt J, Spelman D. Plasmodium species co-infection as a cause of treatment failure. Travel Med Infect Dis. 2011;9:306–9.PubMedCrossRef
24.
go back to reference Hedelius R, Fletcher JJ, Glass WF II, Susanti AI, Maguire JD. Nephrotic syndrome and unrecognized Plasmodium malariae infection in a US Navy sailor 14 years after departing Nigeria. J Travel Med. 2011;18:288–91.PubMedCrossRef Hedelius R, Fletcher JJ, Glass WF II, Susanti AI, Maguire JD. Nephrotic syndrome and unrecognized Plasmodium malariae infection in a US Navy sailor 14 years after departing Nigeria. J Travel Med. 2011;18:288–91.PubMedCrossRef
25.
go back to reference Franken G, Müller-Stöver I, Holtfreter MC, Walter S, Melhorn H, Labisch A, et al. Why do Plasmodium malariae infections sometimes occur in spite of previous antimalarial medication? Parasitol Res. 2012;111:943–6.PubMedCrossRef Franken G, Müller-Stöver I, Holtfreter MC, Walter S, Melhorn H, Labisch A, et al. Why do Plasmodium malariae infections sometimes occur in spite of previous antimalarial medication? Parasitol Res. 2012;111:943–6.PubMedCrossRef
27.
go back to reference Liang SY, Westblade LF, Mehrtens J, Burnham C-AD, Kuhlmann FM. Fever in a 20-year-old returned traveller. Clin Infect Dis. 2013;56:423.PubMedCrossRef Liang SY, Westblade LF, Mehrtens J, Burnham C-AD, Kuhlmann FM. Fever in a 20-year-old returned traveller. Clin Infect Dis. 2013;56:423.PubMedCrossRef
29.
go back to reference Visser R, de Mast Q, Munnix I, van der Ven A, Dofferhoff T. Failure of atovaquone–proguanil chemoprophylaxis and chloroquine treatment in Plasmodium malariae infection. Travel Med Infect Dis. 2016;14:644–5.PubMedCrossRef Visser R, de Mast Q, Munnix I, van der Ven A, Dofferhoff T. Failure of atovaquone–proguanil chemoprophylaxis and chloroquine treatment in Plasmodium malariae infection. Travel Med Infect Dis. 2016;14:644–5.PubMedCrossRef
30.
go back to reference Rutledge GG, Marr I, Lin Huang GK, Auburn S, Marfurt J, Sanders M, et al. Genomic characterization of recrudescent Plasmodium malariae after treatment with artemether/lumefantrine. Emerg Infect Dis. 2017;23:1300–7.PubMedPubMedCentralCrossRef Rutledge GG, Marr I, Lin Huang GK, Auburn S, Marfurt J, Sanders M, et al. Genomic characterization of recrudescent Plasmodium malariae after treatment with artemether/lumefantrine. Emerg Infect Dis. 2017;23:1300–7.PubMedPubMedCentralCrossRef
31.
go back to reference Islam S, Hai F. Recrudescing Plasmodium malariae infection despite appropriate treatment in an immigrant toddler. Paediatr Int Child Health. 2018;38:290–3.PubMedCrossRef Islam S, Hai F. Recrudescing Plasmodium malariae infection despite appropriate treatment in an immigrant toddler. Paediatr Int Child Health. 2018;38:290–3.PubMedCrossRef
33.
go back to reference Anasari HR, Templeton TJ, Subudhi AK, Ramaprasad A, Tang J, Lu F, et al. Genome-scale comparison of expanded gene families in Plasmodium ovale wallikeri and Plasmodium ovale curtisi with Plasmodium malariae and with other Plasmodium species. Int J Parasitol. 2016;46:685–96.CrossRef Anasari HR, Templeton TJ, Subudhi AK, Ramaprasad A, Tang J, Lu F, et al. Genome-scale comparison of expanded gene families in Plasmodium ovale wallikeri and Plasmodium ovale curtisi with Plasmodium malariae and with other Plasmodium species. Int J Parasitol. 2016;46:685–96.CrossRef
34.
go back to reference Rutledge GG, Böhme U, Sanders M, Reid AJ, Cotton JA, Maiga-Ascofare O, et al. Plasmodium malariae and P. ovale genomes provide insights into malaria parasite evolution. Nature. 2017;542:101–4.PubMedPubMedCentralCrossRef Rutledge GG, Böhme U, Sanders M, Reid AJ, Cotton JA, Maiga-Ascofare O, et al. Plasmodium malariae and P. ovale genomes provide insights into malaria parasite evolution. Nature. 2017;542:101–4.PubMedPubMedCentralCrossRef
35.
go back to reference Tazi L, Ayala FJ. Unresolved direction of host transfer of Plasmodium vivax v. Plasmodium simium and P. malariae v P. brasilianum. Infect Genet Evol. 2011;11:209–21.PubMedCrossRef Tazi L, Ayala FJ. Unresolved direction of host transfer of Plasmodium vivax v. Plasmodium simium and P. malariae v P. brasilianum. Infect Genet Evol. 2011;11:209–21.PubMedCrossRef
36.
go back to reference Lalremruata A, Magris M, Vivas-Martinez S, Koehler M, Esen M, Kempaiah P, et al. Natural infection of Plasmodium brasilianum in humans: man and monkey share quartan malaria parasites in the Venezuelan Amazon. EBioMedicine. 2015;2:1186–92.PubMedPubMedCentralCrossRef Lalremruata A, Magris M, Vivas-Martinez S, Koehler M, Esen M, Kempaiah P, et al. Natural infection of Plasmodium brasilianum in humans: man and monkey share quartan malaria parasites in the Venezuelan Amazon. EBioMedicine. 2015;2:1186–92.PubMedPubMedCentralCrossRef
38.
go back to reference Martelli G, Girometti N, Vanino E, Bottieau E, Viale P. Plasmodium falciparum malaria in migrants who transited Libya-Where did they contract malaria? Travel Med Infect Dis. 2015;13:499–500.PubMedCrossRef Martelli G, Girometti N, Vanino E, Bottieau E, Viale P. Plasmodium falciparum malaria in migrants who transited Libya-Where did they contract malaria? Travel Med Infect Dis. 2015;13:499–500.PubMedCrossRef
39.
go back to reference Maguire JD, Sumawinata IW, Masbar S, Laksana B, Prodjodipuro P, Susanti I, et al. Chloroquine-resistant Plasmodium malariae in south Sumatra, Indonesia. Lancet. 2002;360:58–60.PubMedCrossRef Maguire JD, Sumawinata IW, Masbar S, Laksana B, Prodjodipuro P, Susanti I, et al. Chloroquine-resistant Plasmodium malariae in south Sumatra, Indonesia. Lancet. 2002;360:58–60.PubMedCrossRef
40.
go back to reference Collins WE, Jeffery GM. Extended clearance time after treatment of infections with Plasmodium malariae may not be indicative of resistance to chloroquine. Am J Trop Med Hyg. 2002;67:406–10.PubMedCrossRef Collins WE, Jeffery GM. Extended clearance time after treatment of infections with Plasmodium malariae may not be indicative of resistance to chloroquine. Am J Trop Med Hyg. 2002;67:406–10.PubMedCrossRef
41.
go back to reference Schallig HDFH, Tinto H, Sawa P, Kaur H, Duparc S, Ishengoma DS, et al. Randomised controlled trial of two sequential artemisinin-based combination therapy regimens to treat uncomplicated falciparum malaria in African children: a protocol to investigate safety, efficacy and adherence. BMJ Glob Health. 2017;2:e000371.PubMedPubMedCentralCrossRef Schallig HDFH, Tinto H, Sawa P, Kaur H, Duparc S, Ishengoma DS, et al. Randomised controlled trial of two sequential artemisinin-based combination therapy regimens to treat uncomplicated falciparum malaria in African children: a protocol to investigate safety, efficacy and adherence. BMJ Glob Health. 2017;2:e000371.PubMedPubMedCentralCrossRef
42.
go back to reference Teo BH, Landsell P, Smith V, Blaze M, Nolder D, Beshir KB, et al. Delayed onset of symptoms and atovaquone-proguanil chemoprophylaxis breakthrough by Plasmodium malariae in the absence of mutation at codon 268 of pmcytb. PLoS Negl Trop Dis. 2015;9:e0004068.PubMedPubMedCentralCrossRef Teo BH, Landsell P, Smith V, Blaze M, Nolder D, Beshir KB, et al. Delayed onset of symptoms and atovaquone-proguanil chemoprophylaxis breakthrough by Plasmodium malariae in the absence of mutation at codon 268 of pmcytb. PLoS Negl Trop Dis. 2015;9:e0004068.PubMedPubMedCentralCrossRef
43.
go back to reference Richter J, Franken G, Holtfreter MC, Walter S, Labisch A, Mehlhorn H. Clinical implications of a gradual dormancy concept in malaria. Parasitol Res. 2016;115:2139–48.PubMedCrossRef Richter J, Franken G, Holtfreter MC, Walter S, Labisch A, Mehlhorn H. Clinical implications of a gradual dormancy concept in malaria. Parasitol Res. 2016;115:2139–48.PubMedCrossRef
44.
go back to reference Garnham PCC. Malaria parasites of man: life-cycles and morphology (excluding ultrastructure). In: Wernsdorfer WH, McGregor I, editors. Malaria-principles and practice of malariology. Edinburgh: Churchill Livingstone; 1988. p. 61–96. Garnham PCC. Malaria parasites of man: life-cycles and morphology (excluding ultrastructure). In: Wernsdorfer WH, McGregor I, editors. Malaria-principles and practice of malariology. Edinburgh: Churchill Livingstone; 1988. p. 61–96.
45.
go back to reference Kitchen AD, Barbara JAJ, Hewit PE. Documented cases of post-transfusion malaria occurring in England. A review in relation to current and proposed donor-selection guidelines. Vox Sang. 2005;89:77–80.PubMedCrossRef Kitchen AD, Barbara JAJ, Hewit PE. Documented cases of post-transfusion malaria occurring in England. A review in relation to current and proposed donor-selection guidelines. Vox Sang. 2005;89:77–80.PubMedCrossRef
46.
go back to reference Brouwer EE, van Hellemond JJ, van Genderen PJJ, et al. A case report of transfusion-transmitted Plasmodium malariae from an asymptomatic non-immune traveller. Malar J. 2013;12:439.PubMedPubMedCentralCrossRef Brouwer EE, van Hellemond JJ, van Genderen PJJ, et al. A case report of transfusion-transmitted Plasmodium malariae from an asymptomatic non-immune traveller. Malar J. 2013;12:439.PubMedPubMedCentralCrossRef
47.
go back to reference Tiburskaja NA, Vrubleskaja OS. Clinical and experimental studies on quartan malaria following blood transfusion and methods for preventing its occurrence. Bull World Health Organ. 1965;33:843–51.PubMedPubMedCentral Tiburskaja NA, Vrubleskaja OS. Clinical and experimental studies on quartan malaria following blood transfusion and methods for preventing its occurrence. Bull World Health Organ. 1965;33:843–51.PubMedPubMedCentral
49.
go back to reference Sutherland CJ. Persistent parasitism: the adaptive biology of malariae and ovale malaria. Trends Parasitol. 2016;32:808–19.PubMedCrossRef Sutherland CJ. Persistent parasitism: the adaptive biology of malariae and ovale malaria. Trends Parasitol. 2016;32:808–19.PubMedCrossRef
50.
go back to reference Markus MB. New evidence for hynozoite-independent Plasmodium vivax malarial recurrences. Trends Parasitol. 2018;34:1015–6.PubMedCrossRef Markus MB. New evidence for hynozoite-independent Plasmodium vivax malarial recurrences. Trends Parasitol. 2018;34:1015–6.PubMedCrossRef
Metadata
Title
A case of Plasmodium malariae recurrence: recrudescence or reinfection?
Authors
Romualdo Grande
Spinello Antinori
Luca Meroni
Michela Menegon
Carlo Severini
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2019
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/s12936-019-2806-y

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