Relapse of a Plasmodium vivax Infection in an Iranian Patient

Plasmodium vivax is the most prevalent in the malaria endemic areas of Iran. The number of Plasmodium vivax sporozoites that get to the liver remain latent, and after several months or years of inappropriate treatment period, they can reactivate and leads to the clinical manifestation of malaria.
A 49-year-old male was referred to a private clinical center in the capital city of Iran, Tehran, in October 2016 due to fever, chills, nausea, appetite, headache, and weakness. The patient had a history of clinical vivax malaria 1-year prior in Chabahar, in the province of Sistan and Baluchistan. The light microscope and nested PCR were applied for detecting the vivax malaria infection. In this patient, the relapse of P. vivax occurred after about 12 months, following the primary malaria infection.
The report underlines that relapses should be considered in febrile individuals returning from malaria endemic areas of the country to malaria free areas. In addition, it highlights the occurrence of relapse in the patient with history using primaquine for a radical cure of liver latent parasites.