Plasmodium vivax severe malaria case in a children patient in Saint- Louis, Senegal

Abstract

Abstract Background: Infections caused by Plasmodium vivax are underestimated in Sub-Saharan Africa. Several cases have been reported in recent years including in Duffy-negative individuals. Most of the cases are uncomplicated, however severe infections can occur with sometimes poor outcomes. Here, we report the first case of Plasmodium vivax severe infection reported in the north of Senegal. Case presentation: MDD, 12 years old female patient aged has been received at the hospital for fever, abdominal pain and vomiting. The physical examination has revealed a jaundice and a hepatomegaly. The ultrasound exam has confirmed a hepatomegaly and splenomegaly. The biological examination has revealed a severe anemia (Hb=5.5 g/dl), a low level of platelets (92 103 /mm3). The thick and thin blood film yielded negative result at the admission. However, 10 days after hospitalization, the microscopic parasitological examination yielded for the first-time positive result for Plasmodium with parasite density at 660 trophozoites/mL. The medical staff has retained the diagnosis of severe malaria and started the treatment with artesunate. The control of the Giemsa-stained blood smear done several days after was still positive. A first real time PCR has revealed the diagnosis of Plasmodium vivax and the primaquine has been added to the treatment. The case was confirmed by a sequencing method which has revealed three single nucleotide polymorphisms (SNPs). Among these SNPs, two have never been described before. Conclusion: This report has shown the presence of Plasmodium vivax in the north of Senegal which shared a border with Mauritania, an endemic Plasmodium vivax setting. Suggesting a need to improve the surveillance of this pathogen in Senegal and surrounding regions.