8 December 2017 (Friday) - P. knowlesi

This picture appeared in the Facebook Hematology Interest Group today

“28 year old male, had been in Sabah (in Borneo) for 4 weeks. Presented to their GP with headaches, fever and dark urine. No antimalarials taken.

Hb = 139 g/L, WCC = 4.7 x 10^9/L, platelet clumping was evident on the blood film so no platelet count reported.

ICT negative, Illumigene Malaria DNA test positive. Parasite count reported as <0.01%.

As you can see, morphology resembles P. malariae. Confirmation of P. knowlesi was given by PCR performed by the reference laboratory.

The parasite count was unusually low. Previous P. knowlesi infections have presented with a high parasite count.”

I’ve never seen P. knowlesi. I’ve always been under the impression it looks like P. malariae (not that I’ve seen much of that) but I’ve learned something here – “Previous P. knowlesi infections have presented with a high parasite count”.