Plasmodium vivax Malaria: A Case Review and Therapeutic Considerations in an Adult Patient

Abstract

Plasmodium vivax malaria remains a major health problem in tropical countries due

to its high relapse rate and various hematological manifestations that may worsen

the patient’s condition. This case report aimed to describe the clinical

manifestations, laboratory findings, and evaluation of therapeutic rationality in a

patient with Plasmodium vivax malaria during hospitalization. The study was

conducted using a case report method involving a 22-year-old male patient who

presented with periodic fever accompanied by chills for one week after traveling

from a malaria-endemic area. Laboratory examination revealed microcytic

hypochromic anemia, leukopenia, mild thrombocytopenia, and malaria parasites

identified on peripheral blood smear examination. The patient received supportive

therapy including intravenous Ringer Lactate fluid, paracetamol, omeprazole,

domperidone, and ferrous sulfate, as well as definitive therapy consisting of

dihydroartemisinin-piperaquine (DHP) for three days and primaquine for 14 days.

The evaluation showed that most of the therapies administered were in accordance

with national guidelines and WHO recommendations for uncomplicated P. vivax

malaria. However, the absence of glucose-6-phosphate dehydrogenase (G6PD)

enzyme activity testing prior to primaquine administration was considered one of

the limitations in patient management. During hospitalization, the patient showed

clinical improvement without severe complications. The management of P. vivax

malaria requires a comprehensive approach including early diagnosis, rational

therapy, clinical monitoring, and patient education to prevent relapse and improve

therapeutic outcomes.