Browsing by Subject "Plasmodium vivax malaria"

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    The importance of the contribution of rapid test, serological and molecular methods in the diagnosis of two imported malaria cases with atypical microscopy; [Mikroskopide Atipik Gorunumlu Dis Kaynakli Iki Sitma Olgusunda Hizli Test, Serolojik ve Molekuler Yontemlerin Taniya Katkisinin Onemi]
    (Ankara Microbiology Society, 2017) Zorbozan O.; Pullukcu H.; Sahar E.A.; Karakavuk M.; Can H.; Tunali V.; Doskaya M.; Turgay N.; Toz S.; Ozbilgin A.
    Malaria is a widespread and life-threatening disease in tropical and subtropical regions. In patients with typical clinical symptoms, malaria is considered as a preliminary diagnosis if there is a travel history to malaria-endemic areas. The basis of the laboratory diagnosis of malaria is the microscopic examination of Giemsa stained smears. On the other hand, the diagnosis and differentiation of Plasmodium species with microscopic examination may have some difficulties. In the first case, adifferent appearance from the classical Plasmodium vivax erythrocytic forms in infected erythrocytes were detected in 1% of all erythrocytes in thin smear blood preparations of a 26-year-old male with complaints of fever and chills and a story of travel to Nigeria. It was observed that parasitic nuclei were not prominent, and were located in the cytoplasm irregularly as chromatin or dye particles, nucleus fragments similar to Schiiffner's granules in the form of scattered and granular spots were present in some erythrocytes, the cytoplasm of some Plasmodium erythrocytic forms were irregular and nuclei were not seen. There were no Schiiffner's granules in any of the infected erythrocytes. PMvax was detected by the rapid diagnostic test (OptiMAL, DiaMed GmbH, Switzerland), which searches for the antigens of Plasmodium species, in the peripheral blood sample of the patients. The P.vlvax 18S rRNA gene was also detected by the multiplex real-time polymerase chain reaction. Antibodies against Plasmodium species were searched by using the Pan Malaria Antibody CELISA (CeLLabs Pty Ltd, Brookvale, Australia) kit in the patient's serum sample and the optical density (OD) value of the patient sample was measured five times the OD value of the positive control. In the second case, adifferent appearance from the classical P.faldparum erythrocytic forms in infected erythrocytes were detected in 12% of all erythrocytes in thin smear blood preparations of a 31-year-old male who has been suffering from persistent fever, severe headache, pain in the eyes and was known to be working in Nigeria. It was observed that some Plasmodium trophozoites have 1 /3 of the size of erythrocytes such as P.vivax and have non-granular cytoplasm, some erythrocytic forms were round and the nucleus and cytoplasm were hardly distinguished, some of them were seen as crescent and close to the nucleus of the cytoplasm and some erythrocytic forms had characteristically a single nucleus and a scattered cytoplasm, similar to mature trophozoites of P.vivax. Although the Plasmodium young trophozoites were similar to Rvtvax in means of magnitude, the forms in which the nude adhered to the erythrocyte wall were common. There were no Rfalciparum gametocyte forms. Rfalciparum like young trophozoite was observedonly in one of the four smears. P.falciparum was detected by the commercial rapid diagnostic test and Rfalciparum 18S rRNA gene was also detected by the multiplex real-time polymerase chain reaction. Antibody formation against Plasmodium species was not detected in the ELISA test. In these case reports, the importance of the support of rapid diagnostic tests, serological and molecular methods to microscopic diagnosis and species determination of two imported malaria cases were demonstrated.
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    A native mixed Plasmodium falciparum and Plasmodium vivax Malaria case molecularly proven after 22 years in Manisa, Turkey; [Manisa'da 22 Yil Sonra Moleküler Olarak Kanitlanmiş Yerli Plasmodium falciparum ve Plasmodium vivax Karma Enfeksiyonu]
    (Ankara Microbiology Society, 2019) Ok Ü.Z.; Çavuş I.; Sidal U.; Limoncu E.; Özbilgin A.
    Plasmodium falciparum malaria causes about 450.000 deaths every year, mostly in children around the world. The infection is seen in cases coming from abroad and may lead to deaths in Turkey. Many native P.falciparum malaria cases and deaths due to this infection were observed in Turkey during mid 1900's when malaria was epidemic. But only two native cases were reported in the last 50 years, both from Manisa. First case was a one-year old baby who has come to Manisa from Urfa with his family and has never been abroad. He has diagnosed with Plasmodium vivax malaria and treated with chloroquine and primaquine. A previously obtained thin blood film was examined and characteristic P.falciparum rings in red blood cells were observed and the case was published together with photographs as probable P.falciparum and P.vivax mixed infection. After this case, microscopists working in Malaria Control Unit of Manisa were informed about the differentiation of malaria species in thin blood samples. Soon afterward, another case who have never been abroad before were also diagnosed with P.falciparum and P.vivax mixed infection and this case was also published with photographs taken from thin blood samples. As molecular diagnostic methods were not improved and widespread in those years, it could not be applied in both cases. A Giemsa stained thin blood sample of the baby case was incidentally found 22 years afterwards and with the aim of molecular diagnosis, the blood sample on the slide previously processed for DNA isolation, then analysed with "FTD Malaria Differentiation (Fast Track Diagnostics, Luxembourg)" multiplex kit with real-time polymerase chain reaction by using probes special for P.falciparum, P.ovale, P.malariae, P.vivax species. DNA's belonging to P.falciparum and P.vivax were found to be positive, the case is molecularly proved to have P.falciparum and P.vivax mixed infection. This case indicated that Turkey is convenient for the expansion of P.falciparum malaria in terms of the climate and vectors and suggested that the potential danger may increase with the effects of global warming, wars and migrations and may jump to Europe over Turkey. The case which molecularly proved the existence of native P.falciparum malaria in the near future in Turkey, was presented to draw attention to the danger of this infection for Turkey and Europe. © 2019 Ankara Microbiology Society. All rights reserved.
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    Imported Malaria: A Plasmodium falciparum Malaria Case in Turkey with Rarely Seen Blood Stages of Infection; [İmport Sıtma: Nadir Görülen Kan Evreleri ile Türkiye’de Bir Plasmodium falciparum Sıtma Olgusu]
    (Galenos Publishing House, 2021) Öncel K.; Karaağaç L.; Özbilgin A.
    Malaria is an important public health problem, with about 219 million cases, which account for 435 thousand deaths of children in Africa in 2017. The infection is transmitted by female anopheles mosquito, including Plasmodium species pathogen for human. In Turkey, no domestic cases have been reported; however, according to Annual Health Statistics, 214 imported cases were reported in 2017. Although P. vivax exactly was reported in previous years, imported Plasmodium falciparum (P. falciparum) cases have increased in the last few years. Herein, we report a case of a 41-year-old male patient who returned two weeks ago from a one-week African journey. A limited number of different blood stages of the parasite (mature trophozoite, young and mature schizont) have been seen in the examination of the peripheral smear; however, the gametocyte stage was not seen. In the present case, detecting mature stages beside the early forms at the peripheral smear could not eliminate the probability of P. falciparum. To confirm the diagnosis and regulate the treatment protocol, molecular methods were employed to differentiate the potential mixture of infection. In this case study, we propose how to approach an uncertain case of severe falciparum malaria or mixture of malaria infection combined with another Plasmodium species, as a result of limited number of different blood stages of the infection at the peripheral smear. © 2021 Turkish Society for Parasitology.
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    Autochthonous Case of Malaria Prediagnosed as Leukemia; [Lösemi Ön Tanılı Yerli Sıtma Olgusu]
    (Ankara Microbiology Society, 2023) Gülen H.; Türedi̇ Yildirim A.; Çavuş İ.; Türkmen H.; Özbilgin A.
    Malaria is a parasitic disease transmitted by infected female Anopheles mosquitoes. There are five species of Plasmodium species that can infect humans. Of these species, especially P.falciparum and P.vivax pose the greatest threat to human health. In the 2014 report of the World Health Organization, it was reported that there were no locally acquired cases of malaria in 16 countries including Türkiye. Malaria cases originating from outside the country and imported due to migration, travel and working abroad are reported as import cases. In this report, a case of non-imported malaria followed with a preliminary diagnosis of leukemia was presented. A 14-year-old female patient who was admitted to a health institution with complaints of high fever, headache, chills, nausea-vomiting, and diarrhea that had been going on for two weeks, was pre-diagnosed as leukemia and was referred to Manisa Celal Bayar University Faculty of Medicine, Hafsa Sultan Hospital, Department of Pediatric Hematology and after pancytopenia was detected in the complete blood count. The anamnesis of the patient revealed that she had no history of international travel and that she had been prescribed medications such as paracetamol, amoxicillin, and metoclopramide for flu-like complaints while working in the Southeastern Anatolia, Aegean, and Mediterranean Regions of Türkiye. Bone marrow aspiration was performed for the etiological examination of pancytopenia. Giemsa-stained blood smears, rapid diagnostics, and real-time quantative polymerase chain reaction (qRt-PCR) analyses were performed in the medical parasitology laboratory and malaria was suspected in both bone marrow and peripheral blood smears. P.vivax erythrocytic forms and gametocytes were present in abundance in smear preparations stained with Giemsa, and rapid diagnosis kit was positive for P.vivax. The strain was genotyped as P.vivax by qRt-PCR analysis. For the treatment of the patient, airalam (artemether + lumefantrine) tablets were provided with 2 x 4 daily posology for three days after the diagnosis, and primaquine was provided after one week of the diagnosis as 1 x 2 tablets (1 x 15 mg) for 14 days, and the patient was discharged without complications following the treatment regimen. The fight against malaria continues uninterruptedly since the establishment of the Republic of Türkiye. Tropical diseases, especially malaria, is of great importance for Türkiye due to numerous reasons such as its location in the subtropical region where Anopheles mosquitoes are capable of malaria transmission, it is situated at the crossroads on the migration routes between continents where human traffic is busy, there are many people who go abroad for work and most importantly rising temperatures due to climate change. For this reason, this case report is important to emphasize the importance of malaria for the country and to increase the awareness of clinicians and laboratories about malaria and the possibility of autochthonous malaria transmission in Türkiye. © 2023 Ankara Microbiology Society. All rights reserved.