• Arie Altman, Itai Gueta, Tamar Grosman, and Eli Schwartz.
• Department of Medicine 'B', Chaim Sheba Medical Center, Tel Hashomer. Arie.Altman@Sheba.health.gov.il
• Harefuah. 2010 Sep 1;149(9):580-2, 620.

AbstractThe authors review a case of an Indian tourist couple both presenting a clinical picture of intermittent fever, thrombocytopenia and relative leukopenia several days after their arrival to israel. The diagnosis of Plasmodium vivax (P.vivax) malaria was established in both patients and antimalarial treatment with chloroquine was initiated. Shortly after initiating the treatment, the husband developed clinical acute respiratory distress syndrome (ARDS). With symptomatic treatment, the patient recovered within few days. The diagnosis of P. vivax was confirmed by PCR, and was shown to be a single infection with no Plasmodium falciparum as co-infection. Although P. vivax is considered as having a benign course, in contrast to P. falciparum infections, in recent years there have been an increased number of reports of complicated P. vivax malaria, mainly ARDS. Physicians should be aware of the possible complicated course of P. vivax malaria.

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