A mild case of malaria smoldered in a 74-year-old woman for decades before being correctly diagnosed and successfully treated by a research physician affiliated with the National Institute of Allergy and Infectious Diseases (NIAID), according to a report in this weeks New England Journal of Medicine.

The unusual case at more than 46 years, and possibly up to 71 years, the longest known malaria infection on record "reveals how high-tech medicine can shed light even on ancient syndromes," says Joseph M. Vinetz, M.D., a postdoctoral fellow in NIAIDs Laboratory of Parasitic Diseases.

Using an extremely sensitive test that searches for genetic signature sequences of a specific malaria parasite, Dr. Vinetz found evidence of that parasite that had eluded detection in multiple standard smears of blood taken from the patient and examined under a microscope. The genetic test, RT-PCR (reverse transcription-polymerase chain reaction), had recently been developed in the laboratory of an NIAID colleague, Thomas F. McCutchan, Ph.D., primarily for research purposes.

The woman, a native of Greece, came to Dr. Vinetz attention in February 1996 when her daughter, a resident of Baltimore, brought her mother for evaluation to a Johns Hopkins University clinic where Dr. Vinetz works part time. On examination, the woman did not complain of any symptoms but did have an enlarged spleen.

The enlarged spleen, her medical history indicated, was first documented several years earlier during a routine examination in Greece. At that time, she was mistakenly diagnosed with lymphoma and treated with an oral anti-cancer drug, methotrexate, for 10 days.

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Contact: Laurie K. Doepel
ldoepel@nih.gov
301-402-1663
NIH/National Institute of Allergy and Infectious Diseases
4-Feb-1998