Exflagellation in Plasmodium vivax Malaria: Diagnostic Dilemmas and Solutions
Shailendra Rathod
Cleveland Clinic Abu Dhabi, UAE.
Abin Varghese *
Srinivas University, Mangalore, India.
Sam Premkumar Daniel
Al Jalila Children’s Speciality Hospital Dubai, UAE.
*Author to whom correspondence should be addressed.
Abstract
Trophozoites gametocytes and Schizonts are the most common developmental stages of Plasmodium vivax found in human blood. Exflagellation of microgametes occurs in mosquitos but not in humans during the life cycle malaria parasite. Exflagellation can occur in collected human blood and may cause diagnostic confusion with organisms such as spirochetes and trypanosomes. We present an unusual case of exfagellation in a six-year-old male patient with exflagellated microgametes, an unusual form of Plasmodium vivax in a human peripheral blood smear that may create diagnostic confusion with organisms such as spirochetes and trypanosomes.
Keywords: Exfagellation, Plasmodium vivax, malaria, microgametes
How to Cite
Downloads
References
Talapko J, Škrlec I, Alebić T, Jukić M, Včev A. Malaria: The past and the present. Microorganisms. 2019;7(6):179.
World malaria report 2022 [Internet]. [cited May 6, 2023]. Available:https://www.who.int/publications-detail-redirect/9789240064898
Kuehn A, Pradel G. The coming-out of malaria gametocytes. BioMed Research International; 2010.
Delves MJ, Straschil U, Ruecker A, Miguel-Blanco C, Marques S, Dufour AC, Sinden RE. Routine in vitro culture of P. falciparum gametocytes to evaluate novel transmission-blocking interventions. Nature Protocols. 2016;11(9):1668-1680.
Arneth B, Keller C, Schaefer S. Malaria exflagellation in a human peripheral blood smear. IDCases. 2017;10:51.
Billker O, Lindo V, Panico M, Etienne AE, Paxton T, Dell A, Morris HR. Identification of xanthurenic acid as the putative inducer of malaria development in the mosquito. Nature. 1998;392(6673): 289-292.
Tembhare P, Shirke S, Subramanian PG, Sehgal K, Gujral S. Exflagellated microgametes of Plasmodium vivax in human peripheral blood: A case report and review of the literature. Indian Journal of Pathology and Microbiology. 2009;52(2): 252.
Prasad CSBR, Aparna N, Harendra Kumar ML. Exflagellated microgametes of Plasmodium vivax in human peripheral blood: An uncommon feature of malaria. Indian Journal of Hematology and Blood Transfusion. 2011; 27:104-106.