POSTPARTAL ENDOMYOMETRITIS IN A CASE OF UNKNOWN TERTIAN MALARIA

A 28-year-old woman developed puerperal endomyometritis and tertian ma laria simultaneously. She delivered her child by vacuum extraction dur ing meek 41 of pregnancy in September 1994. The peripartal period was uneventful. Nine days post partum the patient was readmitted to hospit al with fever and pain in the area of the episiotomy. On day 13 post p artum a hysterectomy was performed because of suspected abscess-formin g endomyometritis. Two days after the hysterectomy the patient develop ed septic temperatures, which persisted for 10 days. Tertian malaria d ue to Plasmodium vivax was found to be the cause of fever. The patient had been in Indonesia without anti-malarial prophylaxis in 1991. Two years later she travelled to Ghana, having taken mefloquine as prophyl axis, Malaria was obviously caused by reactivated hypnozoites in the l iver, although the patient had never had an episode of fever associate d with malaria before. This case proves that tertian malaria may ''rec ur'' even without previous manifestation, years after a stay in a regi on endemic for malaria.