ACUTE ACQUIRED HEMOLYTIC ANEMIA DUE TO DELAYED PRIMARY ATTACK OF VIVAX MALARIA

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Abstract
Occasionally the recognition of malaria in the delayed primary attack represents a difficult diagnostic problem. In spite of chills and fever the smears may be negative. The onset of a delayed primary attack may be manifested by many unusual pictures, one of which is an acute acquired hemolytic anemia, one case of which is here reported. Even though primaquine and chloroquine are routinely administered to the troops returning from endemic areas, cases of delayed primary attacks of malaria still occur. Some of these have unusually long incubation periods and their symptoms are atypical. Laboratory evidence for active hemolysis was present, but the daily smears were negative for approximately 2.5 months. Until the positive malarial smear was found, the etiology of the acute hemolytic process could not initially be established.

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