RELAPSING PLASMODIUM-VIVAX MALARIA WITH ATYPICAL PARASITE FORMS AND PHAGOCYTOSIS BY PERIPHERAL NEUTROPHILS

A case of atypical Plasmodium vivax malaria is presented. The clinical follow-up has allowed to characterize three consecutive malaria clini cal episodes within one year. At the first attack, 39 % of the infecte d red blood cells were parasitized by gametocytes. Furthermore, rare c risis forms, exceptional <<pseudo-parthenogenesis>> forms, a few equat orial trophozoites, malaria pigment-containing leucocytes and phagocyt ized parasites were also found in the thin blood smears. At the second malaria episode, morphological aspects were quite similar, but the ga metocyte percentage decreased and that oi the equatorial trophozoite f orms increased. Only at the third attack, was the morphology typical o f P. vivax. The Plasmodium species and the absence of mixed infection were unequivocally confirmed using polymerase chain reaction. Atypical strains of P. vivax ore relatively frequent Nevertheless, to our know ledge, neither so high a gametocyte percentage, nor extensive P. vivax peripheral phagocytosis were previously reported.