Relapse of Plasmodium mallariae malaria 20 years after living in an endemic area

Introduction Malaria has been eradicated in Tunisia since 1979. Although it continues to be evoked in the case of fever after travel to an endemic zone, its diagnosis is however difficult during relapses, notably when they are delayed. Observation A 50 year-old man having lived in Mauritania from 1978 to 1982 was hospitalized for interstitial pneumopathy and urarthritis. In spite of treatment with broad spectrum antibiotics, the fever accompanied by abundant sweating persisted. A thick blood drop and blood smear was requested and led to the diagnosis of Plasmodium malariae malaria. Discussion This observation recalls the possibility of parasitic upsurge of some plasmodial species. It should prompt physicians to be careful and evoke malaria in the case of fever in subjects having stayed, even several years before, in an endemic zone. This would permit early diagnosis and treatment.