Page 166 - Medical Parasitology_ A Textbook ( PDFDrive )

14 Case Reports 159

Source: Chiam, K. H., Yvonne AL Lim, Rohela Mahmud, Romano Ngui, and
Lee Lee Low. “Gigantic amoebic liver abscess in pregnancy: A case report.”
Tropical Biomedicine 32, no. 4 (2015): 699–703.

Learning Points
1. Amoebic liver abscess in pregnancy is rare and is associated with high risk of
mortality.
2. It poses diagnostic challenge/dilemma especially when symptoms are vague and
subtle.
3. A combination of a detailed epidemiological history, biochemical, radiographic
and molecular investigations aid in the diagnosis.
4. Elevated alkaline phosphatase alongside leukocytosis guide clinicians towards
the diagnosis of liver abscess.

Case 3: Child Infected with Plasmodium vivax via Blood Transfusion
Case report: A 12-year-old Chinese male child who was diagnosed with intracra-
nial malignant germ cell tumour received packed red cell transfusions for
chemotherapy- induced anaemia. He received blood from 3 donors: a Myanmarese
male and 2 Malaysian donors. A week later, upon returning home, the patient devel-
oped fever with rigors. He was admitted to the hospital and blood film malaria para-
site (BFMP) was carried out.
Giemsa-stained blood smear from the patient was prepared and examined
under light microscope. Examination of the blood smear showed Plasmodium
vivax infection with 0.03% parasitaemia. PCR was carried out on the blood sam-
ples of the patient and the 3 donors to confirm the species of the malaria
parasite.
Based on the PCR results, it was confirmed that the Myanmarese male donor
was infected with P. vivax and the other 2 donors were found to be negative for
malaria. The 26-year-old donor from Sagaing Region, Myanmar came to Malaysia
and worked in Semenyih, Selangor for 3 years. He then returned to Myanmar for
4 months and returned to resume work in Semenyih. Medical history of the donor
did not suggest prior malaria infection nor was there any other significant medical
or surgical history. There was no prior history of receiving blood transfusion
either.

Source: Anthony, Claudia N., Yee-Ling Lau, Jia-Siang Sum, Mun-Yik Fong,
Hany Ariffin, Wai-Linn Zaw, Indra Jeyajothi, and Rohela Mahmud. “Malaysian
child infected with Plasmodium vivax via blood transfusion: a case report.”
Malaria Journal 12, no. 1 (2013): 308.

Learning Points
1. Blood used for transfusion should be free of malarial parasites.
2. Clinicians investigating fever in a patient need to ask about history of recent
transfusion.