doctorboomboomHey thanks for finding the image! Do you know why the answer can’t be Chloroquine resistance? I was b/w that and formation of hypnozoites.+12019-05-20T10:32:56Z
jejunumjediI think it's just that Schuffner stippling and hypnozoites are both specific to vivax and ovale species. These species could be chloroquine resistant or sensitive, but if you have Schuffner stippling or hypnozoites, you can definitively say that it's either vivax or ovale.+12019-05-20T10:33:24Z
sherrySpecies with hypnozoites is not called chloroquine resistant. Chloroquine-resistant species means trophozoite/schizont cant be killed by chloroquine. We dont have enough info to decide whether the spp in the q is resistant/sensitive. But we do know he moved from Honduras to USA 1 year ago.+12019-07-11T12:05:12Z
sophUW: in africa most malaria species are resistant to chloroquine. he is from hondruas+22019-07-28T17:15:30Z
randiosCan anyone explain the 1-week history of fever? Ruled out vivax and ovale due to 48 hr cycles. Or did they just throw that in as an unspecific symptom.+12019-08-07T22:38:17Z
mcm94how I know that is an infection by vivax/ovale ? if there's nothing that says about tertian fever?+2020-02-03T19:12:53Z
medguru2295While it COULD be Chloroquine resistant, its not likely.
This patient is likely infected with Vivax or ovale (not Falciparium) why?
1. Honduras (Falcip would be Africa)
2. Sx 1 year later (Liver form Vivax or OVale)
3. As many mentioned, Schuffer bodies
Falciparium tends to be the species resistant to Chloroquine.
Typically, Chloroquine is given for Vivax & Ovale (typically with something else- Atovaquone, Dapsone etc) to cover Liver
Falciparium (no Liver form) is generally Chloroquine resistant (B) and therefore covered with Atovaquone/Proguanil. You do need 8-14 days of tx after coming for Falcip bc it can remain in the Liver for a few days (just not a dormant hypno form).
To cover the "week of fever" question- its re-emergence of her sx. They probably just did not want to say cyclic to make it trickier.+2020-02-09T01:07:18Z
charcot_bouchardGuys along with all intelligent discussion also keep in mind he immigrated 1 year back. So it must be hypnozoites which is causing this because Murica is Malaria free.+122019-06-26T11:04:05Z