Malaria Journal

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Swedish traveller with Plasmodium knowlesi malaria after visiting Malaysian Borneo

Ulf Bronner1, Paul CS Divis2, Anna Färnert1 and Balbir Singh2*

Author Affiliations

1 Unit of Infectious Diseases, Department of Medicine, Karolinska Institute, Karolinska University Hospital Solna, Stockholm, Sweden

2 Malaria Research Centre, Faculty of Medicine & Health Sciences, University Malaysia Sarawak, 93150 Kuching, Sarawak, Malaysia

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Malaria Journal 2009, 8:15 doi:10.1186/1475-2875-8-15

Published: 16 January 2009

Abstract

Plasmodium knowlesi is typically found in nature in macaques and has recently been recognized as the fifth species of Plasmodium causing malaria in human populations in south-east Asia. A case of knowlesi malaria is described in a Swedish man, who became ill after returning from a short visit to Malaysian Borneo in October 2006. His P. knowlesi infection was not detected using a rapid diagnostic test for malaria, but was confirmed by PCR and molecular characterization. He responded rapidly to treatment with mefloquine. Evaluation of rapid diagnostic kits with further samples from knowlesi malaria patients are necessary, since early identification and appropriate anti-malarial treatment of suspected cases are essential due to the rapid growth and potentially life-threatening nature of P. knowlesi. Physicians should be aware that knowlesi infection is an important differential diagnosis in febrile travellers, with a recent travel history to forested areas in south-east Asia, including short-term travellers who tested negative with rapid diagnostic tests.