Plasmodium malariaeInfection in an Asymptomatic 74-Year-Old Greek Woman with Splenomegaly

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Abstract
Malaria most commonly presents as an acute systemic, febrile illness but may manifest more indolently as chronic anemia, glomerulonephritis, or tropical splenomegaly syndrome (or hyperreactive malarial splenomegaly) due to Plasmodium falciparum, P. vivax, or P. malariae. 1 Although all the major malaria parasites of humans cause acute illness that may be accompanied by splenomegaly, P. malariae is the only one recognized to cause asymptomatic infections that can last decades.1 Asymptomatic P. malariae infections are typically associated with very low levels of parasitemia and normal physical examinations,2,3 and they generally come to medical attention when malaria is transmitted by transfusion2,3 or a recrudescence is induced by splenectomy performed for reasons unrelated to malaria.4