Abstract

A 57-year-old woman with chronic hemodialysis for 16 years, who presented at the Avicenna hospital in Marrakesh with fever and hepatosplenomegaly. Three months earlier, he received 2 units of packed red blood cells. Laboratory studies indicated hemolytic anemia (hemoglobin, 9.5 mg/dl) and thrombocytopenia (platelet count, 105000/mm2). Malaria smear was consistent with Plasmodium malariae. The level of parasetemia was 1% (10 per 1000 erythrocytes). As a result, the patient's antimalarial therapy was continued for a total of 7 days followed by mefloquine for 7 days once the blood smear results revealed P. malariae infection. Evolution was favorable after antimalarial therapy with the disappeanrance of fever and hepatosplenomegaly. The control of parasitaemia remained negative until 28 days. This is the first case of hepatosplenomegaly secondary to blood transfusion related Plasmodium malariae infection in a non-endemic country in chronic hemodialysis.

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