Plasmodium ovale gametocytes in peripheral blood

Lozano-Ochoa, Angela; Galiacho, Verónica Roldán; Ros, Leyre Cristina Jiménez; Garay, Raquel Pérez; García-Ruiz, Juan Carlos

doi:10.1016/j.htct.2023.11.017

Hematology, Transfusion and Cell Therapy

ISSN: 2531-1379

Hematology, Transfusion and Cell Therapy is a quarterly scientific publication of the Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH), Associazione Italo-Brasiliana di Ematologia (AIBE), Eurasian Hematology Oncology Group (EHOG), and Sociedade Brasileira de Oncologia Pediátrica (SOBOPE).

Hematology, Transfusion and Cell Therapy publishes original articles, review articles and case reports covering various areas in the field of hematology and hemotherapy. The journal was previously published, until 2016, as Revista Brasileira de Hematologia e Hemoterapia.

ISSN print: 2531-1379
ISSN online: 2531-1387

Published by Elsevier Editora Ltda, Rio de Janeiro, Brazil.

Consensus of the Brazilian association of hematology, hemotherapy and cellular therapy on patient blood management.

Indexed in:

Web of Science, LILACS, SciELO Brazil, ESCI (Web of Science), Scopus, and PubMed/PMC

A 54-year-old woman attended the emergency room with history of fever and myalgia. She had arrived from the Central African Republic one month previously. On admission, laboratory data showed: hemoglobin 70 g/L, platelets 41 × 109/L, leukocytes 0.76 × 109/L, lactate dehydrogenase 330 U/L [normal: 0–245 U/L], total bilirubin 1.4 mg/dL and C-reactive protein 53.13 mg/L [normal: 0–11 mg/L].

Rapid diagnostic tests for malaria as well as thick film performed upon arrival were negative. A peripheral blood film stained with May-Grünwald and Giemsa showed slightly enlarged red blood cells covered with Schüffner's dots and prominent brown pigment (hemozoin), suggesting infection by plasmodium at the gametocyte stage. The results obtained by quantitative polymerase chain reaction (qPCR) later on confirmed infection by Plasmodium ovale.

Malaria is a parasite infection caused by Plasmodium spp. Traditionally considered the rarest species, in recent years a rise in cases associated with P. ovale has been observed. Trophozoites are the most common morphological finding however, after a long incubation period of this species, gametocytes may be found. 1 Stippling is more pronounced and tends to darken the red blood cell. As P. ovale exclusively infects reticulocytes, the parasite density is typically low.2P. ovale is endemic in western Africa and the Southwest Pacific. The increase in migration flows underscores the need for an early microscopic identification of this infection, in order to achieve a swift diagnosis and guarantee correct treatment.