Abstract
To the editor: We read with great interest the article by Orth et al. [1] in Eurosurveillance on a recent case of imported Plasmodium knowlesi infection in Germany. This case nicely illustrates the pivotal role of microscopy on thick and thin blood films by experienced microscopists for malaria diagnosis. The statement in the discussion section that only five cases imported to Europe have been published so far, underestimates the occurrence of this infection. Two more cases imported to the Netherlands have been described previously [2,3].
Highlights
One case was a migrant worker from Malayan Borneo, positive in microscopy with 2% infected erythrocytes
The rapid BinaxNOW Malaria Test was positive for the pan-malarial aldolase band but negative for P. falciparum histidine-rich protein 2 (HRP-2)
As illustrated by the two cases described above, P. knowlesi infection causes variable results with commercially available rapid diagnostic tests, which do not seem to be reliable for diagnosis of P. knowlesi [3,4]
Summary
One case was a migrant worker from Malayan Borneo, positive in microscopy with 2% infected erythrocytes. The rapid BinaxNOW Malaria Test was positive for the pan-malarial aldolase band but negative for P. falciparum histidine-rich protein 2 (HRP-2). Retrospective analysis of the initial sample showed positive results in the P. falciparum–specific lactate dehydrogenase (LDH) and pan-malarial LDH in the OptiMAL Rapid Malaria Test (DiaMed, Cressier, Switzerland). This patient was successfully treated with oral chloroquine for three days [2].
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