Case Report: Clinically uncomplicated Plasmodium falciparum malaria with high schizontaemia

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Case Report Description:

The following pictures were taken from an unusual case of uncomplicated P.falciparum infection with a trophozoite count of 1.2% of infected RBCs (IRBC) in a patient presenting no clinical signs of severe malaria. The unusual feature, well reported by our lab technician, was the high count of schizonts: 0.3% of IRBC. This triggered the alarm bell for the physician as a potential sign of parasite sequestration meaning the overall parasite biomass in this patient might be much higher than the smear parasitaemia suggested. The presence of mature parasite stages is also associated with worse prognosis. Based on the high schizontaemia the physician wisely decided to hospitalize the patient and treat according to the WHO severe malaria protocol. After a clinical deterioration in the early stage of treatment the patient recovered well. This is likely due to an accurate reporting from the laboratory and a good decision from the clinician.

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