Evidence of Plasmodium falciparum infection after 12 years from the exposure: cryptic malaria or recrudescence?

BackgroundMalaria infections affect a high percentage of the world's population, especially in tropical and subtropical regions. Specifically, Plasmodium falciparum is the most relevant species involved in the etiopathogenesis of this infection. The duration of P. falciparum infections is often undefined, as some reported episodes of suspected recrudescence occur several years after initial exposure.Case presentationWe present a case report of malaria infection with low parasitaemia in a man whose last stay in an endemic region or contacts with the local population was twelve years ago. The patient recovered fully with adequate antimalarial treatment, but some aspects of his clinical history were not clearly defined.ConclusionsWe discuss here the possibility that this is either a P. falciparum recrudescence or an episode of cryptic malaria, as we cannot carefully verify some details of our patient's life and history.

Spontaneous Pathologic Splenic Rupture in a Patient with Plasmodium falciparum Infection, First Case Reported in Israel

Travelers exposed to malaria may develop severe disease and complications. A less well-known complication is spontaneous pathologic splenic rupture, which is still under-reported and has never been reported in Israel. In this paper, we report a 23 years old healthy young man presenting in the emergency department, two weeks after coming back from Sierra Leone, with intermittent fever, mild tachycardia and mild left upper quadrant abdominal pain. The patient was diagnosed with Plasmodium falciparum infection and developed rapidly after hospital admission spleen rupture. He was managed conservatively at first but ultimately underwent splenectomy after being hemodynamically unstable. In the recovery period, the patient developed acute respiratory distress syndrome and was reintubated. A high level of suspicion is recommended in every malaria patient presenting with left upper quadrant abdominal pain, even if minimal. Ultrasonography availability in the internal medicine department may be a critical diagnostic tool, especially in non-endemic areas.