Plasmodium knowlesi in Human, Indonesian Borneo

EID Journal Home > Volume 16, Number 4–April 2010

Volume 16, Number 4–April 2010
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Plasmodium knowlesi in Human, Indonesian Borneo
Melanie Figtree, Rogan Lee, Lisa Bain, Tom Kennedy, Sonia Mackertich, Merrill Urban, Qin Cheng, and Bernard J. Hudson
Author affiliations: Royal North Shore Hospital, Sydney, New South Wales, Australia (M. Figtree, T. Kennedy, S. Mackertich, B.J. Hudson); Westmead Hospital, Sydney (R. Lee); Australian Army Malaria Institute, Enoggera, Queensland, Australia (L. Bain, Q. Cheng); and Mona Vale Hospital, Sydney (M. Urban)

Suggested citation for this article

Abstract
Plasmodium knowlesi is now established as the fifth Plasmodium species to cause malaria in humans. We describe a case of P. knowlesi infection acquired in Indonesian Borneo that was imported into Australia. Clinicians need to consider this diagnosis in a patient who has acquired malaria in forest areas of Southeast Asia.

Plasmodium knowlesi is now recognized as a cause of potentially fatal human malaria in forest areas of Southeast Asia. We describe a case of P. knowlesi malaria acquired in Indonesia and imported to Australia.

The Patient
A 39-year-old man from Australia came to a suburban hospital in Sydney, New South Wales, Australia, with a 2-week history of morning fevers and mild headaches. His symptoms started 13 days after he left Indonesian Borneo (Kalimantan). The patient had spent an average of 10 days per month for the past 18 months working adjacent to a forest area in South Kalimantan Province, Indonesian Borneo. The most recent visit was toward the end of the rainy season. He did not use any personal vector avoidance measures (mosquito nets, long clothing, insect repellent) or receive malaria chemoprophylaxis. The patient did not travel to any other malaria-endemic areas during this 18-month period.

He did not have a remarkable medical history. On examination, he was febrile (38.9°C) and had a heart rate of 88 beats/min, blood pressure of 128/78 mm Hg, normal respiration rate, and oxygen saturation of 99% on room air. Physical examination was unremarkable. Laboratory investigations showed mild thrombocytopenia (106 × 109 cells/L, reference range 150–450 × 109 cells/L), mild leukopenia (3.7 × 109 cells/L, reference range 4.3–10 × 109 cells/L), and unremarkable results for levels of hemoglobin (142 g/L, reference range 130–180 g/L), bilirubin (12 μmol/L, reference value <20 μmol/L), and creatinine (95 μmol/L, reference range 40–120 μmol/L).

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Suggested Citation for this Article
Figtree M, Lee R, Bain L, Kennedy T, Mackertich S, Urban M, et al. Plasmodium knowlesi in human, Indonesian Borneo. Emerg Infect Dis [serial on the Internet]. 2010 Apr [date cited]. http://www.cdc.gov/EID/content/16/4/672.htm

DOI: 10.3201/eid1604.091624