Abstract
BackgroundPlasmodium 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 presentationA 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.ConclusionsPlasmodium malariae is a challenging human malaria parasite and even with the use of molecular techniques the pathogenesis of recurrent episodes cannot be precisely explained.
Highlights
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 polymerase chain reaction (PCR)-confirmed P. malariae recurrence in a 52-year old Italian man was observed 5 months after a primary attack
For instance Plasmodium ovale is credited to produce hypnozoite P. ovale hypnozoites have never been demonstrated biologically. It is described a case of P. malariae infection in an Italian man occurring 5 months after a previous malaria episode despite the fact he had not travelled to a malaria-endemic region
In each of two tested DNA samples, a single amplified product was observed on agarose gel for each analysed target, suggesting the presence of a single detectable isolate for each malaria episode
Summary
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. 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. It is well known that malaria episodes due to P. malariae can occur even after 30–50 years following a previous malaria attack, the mechanism responsible for its persistence and late recurrence still remains a medical mystery [5,6,7,8]. For instance Plasmodium ovale is credited to produce hypnozoite P. ovale hypnozoites have never been demonstrated biologically It is described a case of P. malariae infection in an Italian man occurring 5 months after a previous malaria episode despite the fact he had not travelled to a malaria-endemic region. A review of similar cases is described together with possible explanation of this phenomenon
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