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Table 4 Characteristics of severe P. ovale disease

From: A systematic review of the clinical presentation, treatment and relapse characteristics of human Plasmodium ovale malaria

Authors Diagnostics Parasitaemia Body temperature (°C) Features of severity Treatment Concomitant medication Outcome Comment
Tomar et al. [61] MIC + PCR 39 Bilirubin >50 µm/l, creatinine >265 µm/l, systolic blood pressure <80 mmHg, hemoglobinuria Artesunate iv Ceftriaxone iv, antipyretics Survival without sequelae  
Lemmerer et al. [62] MIC 40.5 Splenic rupture Chloroquine, 2325 mg po over 2 days Survival with sequelae  
Strydom et al. [36] MIC + PCR 1.4% 39.5 Bilirubin >50 µm/l, systolic blood pressure <80 mmHg Quinine, 600 mg iv eight hourly and doxycycline 100 mg twelve hourly Ceftriaxone Survival without sequelae  
Rojo-Marcos et al. [24] MIC + PCR (microscopy neg, PCR positive) Nega Hemoglobin <7 g/dla Survival without sequelaea  
MIC + PCR (microscopy neg, PCR positive) Nega Hemoglobin <7 g/dla Survival without sequelaea  
Lau et al. [8] MIC + PCR 0.18% 40.8 Creatinine >265 µm/l, acidosis, ARDS Chloroquine 150 mg base for 2 days, quinine for 1 day and artesunate for 7 days Ceftriaxone, piperacillin/tazobactam, vancomycin, imipenem, meropenem Death The first antibiotic was started on day 4 despite negative blood cultures; Enterobacter cloacae was found on day 15 (nosocomial sepsis); seizures were described on day 17; atrial fibrillation on day 22; asystole on day 32
Hachimi et al. [42] MIC <0.2% 39 ARDS Quinine Death History of tuberculosis 11 years ago
Lahlou et al. [41] MIC 0.2% ARDS Quinine Ciprofloxacin Death History of treated pulmonary tuberculosis 10 years ago
Roze et al. [63] MIC 0.2% ARDS Chloroquine and quinine Survival without sequelae History of tuberous sclerosis and spontaneous pneumothorax
Coton et al. [64] MIC 40 Acute pericarditis Chloroquine 30 mg/kg over 6 days Ketoprophen, omeprazol, aspirin Survival without sequelae  
Haydoura et al. [65] MIC 1.1% 40 Oxygen saturation <92%, ARDS Quinine iv for 7 days and doxycycline po for 7 days Warfarin Survival without sequelae History of MTHFR, secondary portal vein thrombosis and severe lower gastrointestinal bleeding from hemorrhoids requiring 7 units of red blood cells
Cinquetti [66] MIC + PCR 0.001% 39.5 Splenic infarction Quinine 8 mg/kg iv three times daily Survival with sequelae  
Rojo-Marcos et al. [25] MIC + PCR 6000 trophozoites + gametocytes/µl 40.5 ARDS Chloroquine for 3 days Survival without sequelae History of diabetes mellitus and hypertension; incomplete left bundle block in the predose ECG followed by left ventricular hypertrophy in the day 30 ECG; presence of Mansonella perstans; nosocomial Acinetobacter baumanii in broncho-alveolar aspirate
Rubinstein et al. [67] MIC 0.2% Bilirubin >50 µm/l Quinine for 7 days and doxycycline for 7 days Survival without sequelae  
Filler et al. [68] MIC Hemoglobin <7 g/dl, splenic rupture, cardiac arrest Quinine sulfate and doxycycline, followed by quinidine iv Death History notably of MS
Lee et al. [69] MIC 0.1% 39 Oxygen saturation <92%, pulmonary edema Chloroquine Survival without sequelae Negative blood cultures
Patel [70] MIC Splenic rupture Chloroquine Survival with sequelae  
Facer et al. [9] MIC 1.8% NA Splenic rupture NA NA Death Diagnosis post mortem; absence of P. falciparum confirmed with “DNA analysis”
Monlun et al. [71] MIC 41 Cardiomyopathy Chloroquine 500 mg/day for 5 days Survival without sequelae Cardiomyopathy resolved without additional specific treatment
Bock [72] MIC Hemoglobin <7 g/dl Mepacrine Survival without sequelae Case 2
MIC 40 Cardiac arrhythmia Mepacrine Survival without sequelae Case 15
Fairley [73] MIC 38.3 Hemoglobinuria Mepacrine 0.1 g three times daily for 6 days and quinine bihydrochloride 7.5 g/day iv for 5 days Saline Survival without sequelae  
  1. MIC microscopy, PCR polymerase chain reaction, po per os, iv intravenous, NA not applicable, ARDS acute respiratory distress syndrome, MTHFR methylentetrahydrofolate reductase defect, MS multiple sclerosis, not mentioned in the original publication
  2. aInformation provided by the author