Document Detail

Plasmodium knowlesi malaria in humans is widely distributed and potentially life threatening.
MedLine Citation:
PMID:  18171245     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Until recently, Plasmodium knowlesi malaria in humans was misdiagnosed as Plasmodium malariae malaria. The objectives of the present study were to determine the geographic distribution of P. knowlesi malaria in the human population in Malaysia and to investigate 4 suspected fatal cases. METHODS: Sensitive and specific nested polymerase chain reaction was used to identify all Plasmodium species present in (1) blood samples obtained from 960 patients with malaria who were hospitalized in Sarawak, Malaysian Borneo, during 2001-2006; (2) 54 P. malariae archival blood films from 15 districts in Sabah, Malaysian Borneo (during 2003-2005), and 4 districts in Pahang, Peninsular Malaysia (during 2004-2005); and (3) 4 patients whose suspected cause of death was P. knowlesi malaria. For the 4 latter cases, available clinical and laboratory data were reviewed. RESULTS: P. knowlesi DNA was detected in 266 (27.7%) of 960 of the samples from Sarawak hospitals, 41 (83.7%) of 49 from Sabah, and all 5 from Pahang. Only P. knowlesi DNA was detected in archival blood films from the 4 patients who died. All were hyperparasitemic and developed marked hepatorenal dysfunction. CONCLUSIONS: Human infection with P. knowlesi, commonly misidentified as the more benign P. malariae, are widely distributed across Malaysian Borneo and extend to Peninsular Malaysia. Because P. knowlesi replicates every 24 h, rapid diagnosis and prompt effective treatment are essential. In the absence of a specific routine diagnostic test for P. knowlesi malaria, we recommend that patients who reside in or have traveled to Southeast Asia and who have received a "P. malariae" hyperparasitemia diagnosis by microscopy receive intensive management as appropriate for severe falciparum malaria.
Janet Cox-Singh; Timothy M E Davis; Kim-Sung Lee; Sunita S G Shamsul; Asmad Matusop; Shanmuga Ratnam; Hasan A Rahman; David J Conway; Balbir Singh
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  46     ISSN:  1537-6591     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-03     Completed Date:  2008-02-26     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  165-71     Citation Subset:  IM    
Malaria Research Centre, Faculty of Medicine and Health Sciences, University Malaysia Sarawak, Kuching, Sarawak, Malaysian Borneo.
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MeSH Terms
Aged, 80 and over
Child, Preschool
Fatal Outcome
Malaria / drug therapy,  epidemiology*,  parasitology*
Malaysia / epidemiology
Middle Aged
Plasmodium knowlesi / genetics,  isolation & purification*
Polymerase Chain Reaction / methods
Sensitivity and Specificity
Grant Support
078538//Wellcome Trust; //Wellcome Trust
Comment In:
Clin Infect Dis. 2008 Jan 15;46(2):172-3   [PMID:  18171246 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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