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Korean J Parasitol > Volume 32(3):1994 > Article

Case Report
Korean J Parasitol. 1994 Sep;32(3):195-200. Korean.
Published online Sep 20, 1994.  http://dx.doi.org/10.3347/kjp.1994.32.3.195
Copyright © 1994 by The Korean Society for Parasitology
Occurrence of tertian malaria in a male patient who has never been abroad
I H Chai,1G I Lim,1S N Yoon,1W I Oh,2S J Kim,2 and J Y Chai*3
1Department of General Internal Medicine, Capital Armed Forces General Hospital, Seoul 157-010, Korea.
2Department of Clinical Pathology, Capital Armed Forces General Hospital, Seoul 157-010, Korea.
3Department of Parasitology, Seoul National University College of Medicine, Seoul 110-799, Korea.
Received June 22, 1994; Accepted July 20, 1994.

Abstract

Malaria is estimated to have a worldwide incidence of more than 100 million clinical cases and approximately 1 million deaths per year. Korea, although previously known as an endemic area of tertian malaria (Plasmodium vivax), has been considered free from malaria as there had been no report on indigenous cases since 1984. Recently, however, we experienced an indigenous case of P. vivax infection in a young man who had never been abroad. The patient was a 23-year-old Korean soldier with 18-day history of recurrent fever and chill lasting 4 to 8 hours on alternative days since mid-July 1993. He had lived in Changwon, Kyongsangnam-do, before entering barracks located in Paju-gun, Kyonggi-do on June 1992, and had never been out of Korea. He had no history of blood transfusion nor parenteral use of drugs. The peripheral blood smears showed typical ring forms, trophozoites, and gametocytes of P. vivax, in addition to mild anemia and thrombocytopenia. After confirmation of the diagnosis, he was treated with hydroxychloroquine and primaquine. Follow-up blood smears no more revealed malaria parasites. It is not certain whether the present case is due to a resurgence of indigenous malaria or a secondary infection from introduced malaria. Whichever the source of infection the domestic occurrence of malaria cycle in Korea should be a warning sign in public health point of view.

Figures


Figs. 1-4
Various erythrocytic stages (1-2. ring forms, 3. Immature schizont, 4. gametocte) of Plasmodium vivax, with enlargement and discoloration of the infected red bolld cells, from thin blood smears of the present patient. Giemsa stain (modified). × 1,000.


Fig. 5
The fever curve of the present tertian malaria (P. vivax) case, before and after treatment with hydroxychloroquine and primaquine, during the hospitalized days (4-16 August, 1993).

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