Gert van der Hoek
In Memoriam - Editor, Senior Moderator
11/Oct/2018
A case of severe Plasmodiumfalciparum malaria was diagnosed in August 2018 in a Moroccan man living in Tuscany, Italy. Malaria was initially not considered by the managing clinicians because the patient reported to have not recently visited any endemic country, leading to diagnostic delay and severe anaemia.
Here we describe the clinical and epidemiological features of this case and discuss different hypotheses on the possible route of transmission.
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The presented case, together with other P. falciparum malaria cases recently reported from Apulia, may suggest the occurrence of sporadic autochthonous P. falciparum during the summer season in Italy. However, considering that the susceptibility to P. falciparum infection of the anthropophilic Anopheles species present in Tuscany area is very low, and that the possibility of unrevealed risk factors for acquiring malaria cannot be completely excluded, the presented case remains cryptic. Some travellers may inadvertently or deliberately fail to mention that they have recently been in an endemic area [25].
The fact that four patients recently diagnosed with P. falciparum malaria in Italy were Moroccan citizens remains difficult to explain, considering that Morocco is a malaria-free country. In our patient, malaria diagnosis was delayed because of the missing history of a recent visit to a malaria endemic area. In this perspective, clinicians should consider malaria as one possible differential diagnosis in patients with compatible clinical and laboratory features, even if they do not report a clear exposure to endemic countries.
A case of severe Plasmodiumfalciparum malaria was diagnosed in August 2018 in a Moroccan man living in Tuscany, Italy. Malaria was initially not considered by the managing clinicians because the patient reported to have not recently visited any endemic country, leading to diagnostic delay and severe anaemia.
Here we describe the clinical and epidemiological features of this case and discuss different hypotheses on the possible route of transmission.
..................................................
The presented case, together with other P. falciparum malaria cases recently reported from Apulia, may suggest the occurrence of sporadic autochthonous P. falciparum during the summer season in Italy. However, considering that the susceptibility to P. falciparum infection of the anthropophilic Anopheles species present in Tuscany area is very low, and that the possibility of unrevealed risk factors for acquiring malaria cannot be completely excluded, the presented case remains cryptic. Some travellers may inadvertently or deliberately fail to mention that they have recently been in an endemic area [25].
The fact that four patients recently diagnosed with P. falciparum malaria in Italy were Moroccan citizens remains difficult to explain, considering that Morocco is a malaria-free country. In our patient, malaria diagnosis was delayed because of the missing history of a recent visit to a malaria endemic area. In this perspective, clinicians should consider malaria as one possible differential diagnosis in patients with compatible clinical and laboratory features, even if they do not report a clear exposure to endemic countries.