Where Malaria Is Not Endemic: An Imported Italian Case

Background Malaria is an endemic disease of tropical regions, but the increasing long-distance travel has changed the epidemiological characteristics augmenting the number of cases even in nonendemic countries like Europe. Case Report A 39 yo guy, after coming back from a journey in Nigeria was accepted to ED due fever, chills, and pruritus. He was alert and oriented in space and time with stable vital signs. His history was mute for any notable diseases. General PE was normal except a reduced vesicular murmur in right basal lung. At blood examination there were leucopenia 2300 with an increased index of flogosis (PCR 7 mg/dl e PCT 6.11 ng/ml), thrombocytopenia (56000 u/l) with normal Hb and RBC; furthermore, there was an AKI (creatinine 1.25 mg/dl) with increased GGT (161 u/l) and triglycerides (314 mg/dl). At US there was a splenomegaly. After excluded infectious diseases, endocarditis, sepsis, fever continued with a tertian trend even peaking 40°C unresponsive to paracetamol. We supposed malaria due his travel in endemic area and other predictive index that was confirmed with PCR, so the patient was transferred in infectious disease department to continue the treatment. Conclusion In nonendemic area malaria remains a challenge diagnosis, that’s why is important increasing parasitological exams in patients that return from endemic area to start the treatment as soon as possible avoiding mortality.

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