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Plasmodium Ovale


Presentation

  • And 5 weeks after the completion of treatment, he presented with fever and diagnosed as P. ovale infection. P. ovale infection is a rare cause of malaria and often shows delayed presentation due to its dormant liver stage as hypnozoites.[ncbi.nlm.nih.gov]
  • The epidemiology of mixed infections, likely pathophysiology of his presentation, and the implications for malaria testing and treatment in returned travellers are discussed.[ncbi.nlm.nih.gov]
  • The case presented showed consistent temporal, clinical, and laboratory evidence that the relapse or the long incubation period of P. ovale malaria may have been triggered by a recent DF episode.[ncbi.nlm.nih.gov]
  • Here, the case of a 16-year-old male, who presented with fevers to the outpatient department in Vienna, Austria, after travelling to Uganda and Papua New Guinea is described.[ncbi.nlm.nih.gov]
  • No mixed infections were identified in which both species were present.[doi.org]
Asymptomatic
  • Malariae Was Found In Asymptomatic Blood Donors. The Proportion Of Mixed Infections Involving Three Species Was Also Unexpected.[ncbi.nlm.nih.gov]
  • In all age groups, most infections were asymptomatic. Only high parasitaemias were significantly associated with fever; 3 clinical malaria attacks due to P. ovale were seen during the study period.[ncbi.nlm.nih.gov]
  • Both P. ovale curtisi and P. ovale wallikeri occur sympatrically in the Chittagong Hill Tracts, Bangladesh and all patients presented with a mild or asymptomatic symptom complex at the time of diagnosis.[ncbi.nlm.nih.gov]
  • The prevalence of P. ovale and P. malariae infections in asymptomatic individuals were high during the first years of the project but decreased after 2004 and almost disappeared in 2010 in relation to changes in malaria control policies.[ncbi.nlm.nih.gov]
  • Abstract Two hundred and seventy four asymptomatic Ghanaian school-children aged 5 to 17 years were screened for malaria parasites by examination of blood films.[researchonline.lshtm.ac.uk]
Hyperthermia
  • Owing to the erratic nature of hyperthermia, individual observations were considered to be asymptomatic controls if the temperature was Analysis of the occurrence of P. ovale malaria attacks To take into account the interdependence of successive observations[academic.oup.com]
Scleral Icterus
  • Examination demonstrated scleral icterus, splenomegaly, and anemia. By peripheral blood smear, the patient was diagnosed with Plasmodium ovale.[ncbi.nlm.nih.gov]
Suggestibility
  • As in the majority other described cases of splenic infarction, the course was spontaneously favourable, suggesting that this complication was relatively benign compared to splenic rupture, which is life-threatening and usually necessitating surgery.[ncbi.nlm.nih.gov]
  • The recent increase in the number of people travelling to regions where P. ovale is endemic, suggests that a PCR-based protocol should be included as a complementary tool for malaria reference laboratories.[ncbi.nlm.nih.gov]
  • Travelers returned from risk areas with symptoms suggestive of malaria, should not have the diagnosis of P. ovale (or P. vivax) infection discounted, despite a history of compliance with a standard chemoprophylactic regimen.[ncbi.nlm.nih.gov]
  • Phylogenetic analysis showed two major genetic clusters, suggesting amplification of two distinct gene sets and/or P. ovale variants from each sample.[ncbi.nlm.nih.gov]
  • Furthermore, the relatively high frequency of imported cases of symptomatic P. ovale infection in the United Kingdom suggests that the morbidity caused by ovale malaria has been underestimated.[ncbi.nlm.nih.gov]

Workup

  • A sepsis workup was performed including blood- and urine culture, and a microscopic examination of the urine sediment. Because of maternal malaria infection, malaria screening of the neonate was included.[pediatric-infectious-disease.imedpub.com]
Bilateral Pulmonary Infiltrate
  • On the second day of treatment the patient developed respiratory failure, requiring intubation and ventilatory support with new bilateral pulmonary infiltrates.[ncbi.nlm.nih.gov]
Lymphocytopenia
  • Laboratory tests showed anaemia (haemoglobin 11.4 g/dl), severe thrombocytopaenia (platelets 30 10(9)/mm(3)), leukopenia (3650/mm(3)), lymphocytopenia (650/mm(3)).[ncbi.nlm.nih.gov]
Liver Biopsy
  • Infected mosquitoes were allowed to feed on the patient on three different days, 5, 6, and 9 days before a liver biopsy was performed.[doi.org]

Treatment

  • According to the hospital's malaria treatment guidelines for severe malaria, treatment consisted of intravenous quinine at hour 0 (start of treatment) and 24 h after initial treatment, followed by artemether-lumefantrine 24 h later.[ncbi.nlm.nih.gov]
  • Modelling revealed that mass screening and treatment with highly sensitive quantitative real-time PCR, or MDA with blood-stage treatment alone, would have only a transient effect on P. vivax transmission levels, while MDA that includes liver-stage treatment[ncbi.nlm.nih.gov]
  • Twenty-eight days follow-up after treatment led to detection of a third parasite species in the blood of these two patients suggesting covert co-infection and a delayed appearance of one cryptic species following treatment.[ncbi.nlm.nih.gov]
  • Consecutively, there is a lack of systematic evaluation of the clinical presentation, appropriate treatment and relapse characteristics of P. ovale malaria.[ncbi.nlm.nih.gov]
  • In this case clinical failure of oral chloroquine treatment with clinical progression towards acute respiratory distress syndrome is described.[ncbi.nlm.nih.gov]

Etiology

  • In conclusion, P. ovale should be considered as an etiology in the imported malaria in Korea, because the number of travelers to P. ovale endemic regions has recently increased.[ncbi.nlm.nih.gov]
  • It rarely causes severe illness or death. [2] Etiology P. ovale malaria like other types of malaria infection begins when a female Anopheles mosquito bites and inoculates plasmodial sporozoites from its salivary gland during feeding.[ncbi.nlm.nih.gov]
  • […] clinically by fever, anemia and splenomegaly and is caused by apicomplexan parasites of the genus Plasmodium P. vivax infections occur in both tropical and temperate zones, between 45 N and 40 S ( WHO: Malaria [Accessed 10 January 2018] ) Pathophysiology / etiology[pathologyoutlines.com]

Epidemiology

  • Additional epidemiological data were taken from a database of 1045 imported cases. None.[ncbi.nlm.nih.gov]
  • Then the relationships between the occurrence of P. ovale clinical malaria and a series of entomological, epidemiological, and genetic factors were investigated. There was no increased risk of fever when the P. ovale parasite count was[ncbi.nlm.nih.gov]
  • The epidemiology of mixed infections, likely pathophysiology of his presentation, and the implications for malaria testing and treatment in returned travellers are discussed.[ncbi.nlm.nih.gov]
  • Research on the epidemiology and control of malaria in the Sudan savanna of West Africa, 1980 Geneva World Health Organization Rogier et al., 1996 Evidence for an age-dependent pyrogenic threshold of Plasmodium falciparum parasitemia in highly endemic[doi.org]
  • As symptoms had persisted up to day 14, malaria was also considered, based on the patient's long-standing epidemiological history.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • The epidemiology of mixed infections, likely pathophysiology of his presentation, and the implications for malaria testing and treatment in returned travellers are discussed.[ncbi.nlm.nih.gov]
  • A better genotyping of P. ovale types may improve a better characterization of the clinical pathophysiology for each.[ncbi.nlm.nih.gov]
  • The pathophysiology of P. falciparum as the leading cause of severe malaria has been examined extensively.[malariajournal.biomedcentral.com]
  • Pathophysiology The life cycle of P. ovale includes hypnozoites, which are dormant stages in the liver. These stages can be reactivated in weeks, months, or years after the initial infection, causing disease relapse.[ncbi.nlm.nih.gov]
  • […] characterized clinically by fever, anemia and splenomegaly and is caused by apicomplexan parasites of the genus Plasmodium P. vivax infections occur in both tropical and temperate zones, between 45 N and 40 S ( WHO: Malaria [Accessed 10 January 2018] ) Pathophysiology[pathologyoutlines.com]

Prevention

  • However, it remains possible that localised geographic, temporal or ecological barriers exist within endemic countries which prevent recombination between the genomes of the two species.[ncbi.nlm.nih.gov]
  • Previous infection with P. ovale did not prevent reinfection, but resulted in reduced levels of parasitemia and fever.[ncbi.nlm.nih.gov]
  • Although morphologically very similar, the two taxa must possess distinct characters which prevent recombination between them.[ncbi.nlm.nih.gov]
  • University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan; Department of Microbiology and Immunology, Weill Cornell Medical College, New York 10021, USA. 3 Key Laboratory of National Health and Family Planning Commission on Parasitic Disease Control and Prevention[ncbi.nlm.nih.gov]
  • We report a case of a patient returning from Cameroon who developed Plasmodium ovale malaria, despite atovaquone/proguanil (AP, Malarone) prophylaxis, which is widely used for the prevention of chloroquine-resistant malaria.[ncbi.nlm.nih.gov]

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