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D'Abramo A, Gebremeskel Tekle S, Iannetta M, Scorzolini L, Oliva A, Paglia MG, Corpolongo A, Nicastri E. Severe Plasmodium ovale malaria complicated by acute respiratory distress syndrome in a young Caucasian man. Malar J 2018; 17:139. [PMID: 29609605 PMCID: PMC5879577 DOI: 10.1186/s12936-018-2289-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/23/2018] [Indexed: 11/13/2022] Open
Abstract
Background Although Plasmodium ovale is considered the cause of only mild malaria, a case of severe malaria due to P. ovale with acute respiratory distress syndrome is reported. Case presentation A 37-year old Caucasian man returning home from Angola was admitted for ovale malaria to the National Institute for Infectious Diseases Lazzaro Spallanzani in Rome, Italy. Two days after initiation of oral chloroquine treatment, an acute respiratory distress syndrome was diagnosed through chest X-ray and chest CT scan with intravenous contrast. Intravenous artesunate and oral doxycycline were started and he made a full recovery. Conclusion Ovale malaria is usually considered a tropical infectious disease associated with low morbidity and mortality. However, severe disease and death have occasionally been reported. In this case clinical failure of oral chloroquine treatment with clinical progression towards acute respiratory distress syndrome is described.
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Affiliation(s)
- Alessandra D'Abramo
- National Institute of Infectious Diseases, IRCCS, Lazzaro Spallanzani, Via Portuense 292, 00149, Rome, Italy
| | - Saba Gebremeskel Tekle
- National Institute of Infectious Diseases, IRCCS, Lazzaro Spallanzani, Via Portuense 292, 00149, Rome, Italy.
| | - Marco Iannetta
- National Institute of Infectious Diseases, IRCCS, Lazzaro Spallanzani, Via Portuense 292, 00149, Rome, Italy
| | - Laura Scorzolini
- National Institute of Infectious Diseases, IRCCS, Lazzaro Spallanzani, Via Portuense 292, 00149, Rome, Italy
| | - Alessandra Oliva
- National Institute of Infectious Diseases, IRCCS, Lazzaro Spallanzani, Via Portuense 292, 00149, Rome, Italy
| | - Maria Grazia Paglia
- National Institute of Infectious Diseases, IRCCS, Lazzaro Spallanzani, Via Portuense 292, 00149, Rome, Italy
| | - Angela Corpolongo
- National Institute of Infectious Diseases, IRCCS, Lazzaro Spallanzani, Via Portuense 292, 00149, Rome, Italy
| | - Emanuele Nicastri
- National Institute of Infectious Diseases, IRCCS, Lazzaro Spallanzani, Via Portuense 292, 00149, Rome, Italy
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Groger M, Fischer HS, Veletzky L, Lalremruata A, Ramharter M. A systematic review of the clinical presentation, treatment and relapse characteristics of human Plasmodium ovale malaria. Malar J 2017; 16:112. [PMID: 28284211 PMCID: PMC5346189 DOI: 10.1186/s12936-017-1759-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/28/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Despite increased efforts to control and ultimately eradicate human malaria, Plasmodium ovale malaria is for the most part outside the focus of research or public health programmes. Importantly, the understanding of P. ovale-nowadays regarded as the two distinct species P. ovale wallikeri and P. ovale curtisi-largely stems from case reports and case series lacking study designs providing high quality evidence. Consecutively, there is a lack of systematic evaluation of the clinical presentation, appropriate treatment and relapse characteristics of P. ovale malaria. The aim of this systematic review is to provide a systematic appraisal of the current evidence for severe manifestations, relapse characteristics and treatment options for human P. ovale malaria. METHODS AND RESULTS This systematic review was performed according to the PRISMA guidelines and registered in the international prospective register for systematic reviews (PROSPERO 2016:CRD42016039214). P. ovale mono-infection was a strict inclusion criterion. Of 3454 articles identified by the literature search, 33 articles published between 1922 and 2015 met the inclusion criteria. These articles did not include randomized controlled trials. Five prospective uncontrolled clinical trials were performed on a total of 58 participants. P. ovale was sensitive to all tested drugs within the follow-up periods and on interpretable in vitro assays. Since its first description in 1922, only 18 relapsing cases of P. ovale with a total of 28 relapse events were identified in the scientific literature. There was however no molecular evidence for a causal relationship between dormant liver stages and subsequent relapses. A total of 22 severe cases of P. ovale malaria were published out of which five were fatal. Additionally, two cases of congenital P. ovale malaria were reported. CONCLUSIONS Current knowledge of P. ovale malaria is based on small trials with minor impact, case reports and clinical observations. This systematic review highlights that P. ovale is capable of causing severe disease, severe congenital malaria and may even lead to death. Evidence for relapses in patients with P. ovale malaria adds up to only a handful of cases. Nearly 100 years after P. ovale's first description by Stephens the evidence for the clinical characteristics, relapse potential and optimal treatments for P. ovale malaria is still scarce.
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Affiliation(s)
- Mirjam Groger
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Hannah S. Fischer
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Luzia Veletzky
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | | | - Michael Ramharter
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
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Tomar LR, Giri S, Bauddh NK, Jhamb R. Complicated malaria: A rare presentation of Plasmodium ovale. Trop Doct 2015; 45:140-2. [DOI: 10.1177/0049475515571989] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Malaria has emerged as a major public health problem worldwide. Complications are commonly seen in Plasmodium falciparum ( P. falciparum) and Plasmodium vivax ( P. vivax) infection, but due to Plasmodium ovale ( P. ovale) infection is rarely described in literature. Here we report a case of severe disease due to P. ovale infection complicated with jaundice, thrombocytopenia, hypotension and acute renal failure.
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Affiliation(s)
- Laxmikant Ramkumarsingh Tomar
- Senior Resident, Department of Medicine, University College of Medical Sciences & Guru Teg Bahadur Hospital (University of Delhi), Delhi, India
| | - Subhash Giri
- Professor, Department of Medicine, University College of Medical Sciences & Guru Teg Bahadur Hospital (University of Delhi), Delhi, India
| | - Nitesh Kumar Bauddh
- Postgraduate Resident, Department of Medicine, University College of Medical Sciences & Guru Teg Bahadur Hospital (University of Delhi), Delhi, India
| | - Rajat Jhamb
- Associate Professor, Department of Medicine, University College of Medical Sciences & Guru Teg Bahadur Hospital (University of Delhi), Delhi, India
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Strydom KA, Ismail F, Frean J. Plasmodium ovale: a case of not-so-benign tertian malaria. Malar J 2014; 13:85. [PMID: 24612535 PMCID: PMC3984724 DOI: 10.1186/1475-2875-13-85] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 03/02/2014] [Indexed: 12/23/2022] Open
Abstract
Severe malaria is most commonly associated with Plasmodium falciparum. Plasmodium vivax is increasingly recognized as being capable of causing severe disease. In contrast, Plasmodium ovale is considered as a cause of benign disease and evidence supporting the occurrence of severe or complicated ovale infection is rare. This report describes a case of severe P. ovale infection in a patient presenting with jaundice, respiratory distress, severe thrombocytopenia, petechiae, and hypotension. He had no apparent underlying risk factors for severe disease.
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Affiliation(s)
- Kathy-Anne Strydom
- National Health Laboratory Services, Tshwane Academic Division, Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa.
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Mellon G, Ficko C, Thellier M, Kendjo E, Aoun O, Adriamanantena D, Rapp C. Two cases of late Plasmodium ovale presentation in military personnel. J Travel Med 2014; 21:52-4. [PMID: 24205853 DOI: 10.1111/jtm.12077] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Only a few late cases of Plasmodium ovale presentation have been reported in literature. We describe two cases of late P. ovale presentation occurring in two French military personnel, 47 and 69 months, respectively, after a stay in Côte d'Ivoire and in the absence of new intercurrent malaria exposure.
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Affiliation(s)
- Guillaume Mellon
- Service de Pathologie Infectieuse et Tropicale, Hôpital d'Instruction des Armées Bégin, Saint-Mandé, France
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Lau YL, Lee WC, Tan LH, Kamarulzaman A, Syed Omar SF, Fong MY, Cheong FW, Mahmud R. Acute respiratory distress syndrome and acute renal failure from Plasmodium ovale infection with fatal outcome. Malar J 2013; 12:389. [PMID: 24180319 PMCID: PMC4228392 DOI: 10.1186/1475-2875-12-389] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Accepted: 10/24/2013] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Plasmodium ovale is one of the causative agents of human malaria. Plasmodium ovale infection has long been thought to be non-fatal. Due to its lower morbidity, P. ovale receives little attention in malaria research. METHODS Two Malaysians went to Nigeria for two weeks. After returning to Malaysia, they fell sick and were admitted to different hospitals. Plasmodium ovale parasites were identified from blood smears of these patients. The species identification was further confirmed with nested PCR. One of them was successfully treated with no incident of relapse within 12-month medical follow-up. The other patient came down with malaria-induced respiratory complication during the course of treatment. Although parasites were cleared off the circulation, the patient's condition worsened. He succumbed to multiple complications including acute respiratory distress syndrome and acute renal failure. RESULTS Sequencing of the malaria parasite DNA from both cases, followed by multiple sequence alignment and phylogenetic tree construction suggested that the causative agent for both malaria cases was P. ovale curtisi. DISCUSSION In this report, the differences between both cases were discussed, and the potential capability of P. ovale in causing severe complications and death as seen in this case report was highlighted. CONCLUSION Plasmodium ovale is potentially capable of causing severe complications, if not death. Complete travel and clinical history of malaria patient are vital for successful diagnoses and treatment. Monitoring of respiratory and renal function of malaria patients, regardless of the species of malaria parasites involved is crucial during the course of hospital admission.
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Affiliation(s)
- Yee-Ling Lau
- Tropical Infectious Disease Research and Education Center (TIDREC), Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Wenn-Chyau Lee
- Tropical Infectious Disease Research and Education Center (TIDREC), Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Lian-Huat Tan
- Sunway Medical Centre, Bandar Sunway, 46150 Petaling Jaya, Selangor, Malaysia
| | - Adeeba Kamarulzaman
- Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | | | - Mun-Yik Fong
- Tropical Infectious Disease Research and Education Center (TIDREC), Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Fei-Wen Cheong
- Tropical Infectious Disease Research and Education Center (TIDREC), Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Rohela Mahmud
- Tropical Infectious Disease Research and Education Center (TIDREC), Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Hachimi MA, Hatim EA, Moudden MK, Elkartouti A, Errami M, Louzi L, Hanafi SM, Mahmoudi A. [The acute respiratory distress syndrome in malaria: is it always the prerogative of Plasmodium falciparum?]. REVUE DE PNEUMOLOGIE CLINIQUE 2013; 69:283-286. [PMID: 23688721 DOI: 10.1016/j.pneumo.2013.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 03/10/2013] [Accepted: 03/11/2013] [Indexed: 06/02/2023]
Abstract
Severe malaria causes nearly one million deaths annually in endemic areas and is a public health priority worldwide. Severity associated with the occurrence of acute respiratory distress syndrome (ARDS) is a well-known complication of infection with Plasmodium falciparum and can reach 25% of infected adults. However, ARDS is less often described with other Plasmodium species. We report the case of a young Moroccan soldier who died in an array of ARDS related to malaria of Plasmodium ovale 7 months after his return from an endemic country.
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Affiliation(s)
- M A Hachimi
- Pôle d'anesthésie réanimation et urgences, hôpital militaire d'instruction Moulay Ismaïl, Meknès, Maroc.
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Demaison X, Rapp C, de Laval F, Simon F. Malaria attacks due to P. vivax or P. ovale in two French military teaching hospitals (2000 to 2009). Med Mal Infect 2013; 43:152-8. [DOI: 10.1016/j.medmal.2013.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 11/12/2012] [Accepted: 01/09/2013] [Indexed: 01/01/2023]
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