Diagnostic and Therapeutic Pitfalls Associated with Primaquine-Tolerant Plasmodium vivax

ABSTRACT

We describe a U.S. Army Ranger returning from duty in Afghanistan and Iraq with life-threatening infection due to Plasmodium vivax. Morphological variants were observed in blood films prepared using samples collected by venipuncture. The patient's multiple relapses indicate infection with primaquine-tolerant P. vivax. Strategies for relapse prevention using primaquine are reviewed.