Coagulation defect in the fifth species of human malaria: A topic that has never beensystematically addressed

Dear Sir,

Malaria is an important tropical infection that is accepted for its global importance. However, in the past few years, the newest fifth species of human malaria Plasmodiumknowlesi was documented. ^[1] From its origin in Malaysia, there have been several reports of malaria by this species in several countries worldwide. This disease is a zoonosis and can be easily misdiagnosed as P. malariae infection. ^[1] Apart from the acute febrile presentation, an importantpathological condition of the fifth species malaria, which is rarely mentioned, is the disturbanceof coagulation. Indeed, it has been confirmed that P. knowlesi malaria can induce coagulopathy in animals.

In a simian model, “the occurrence of intravascular coagulation during the last 48hours of the disease, concurrent with a marked fall in hematocrit levels” has been reported. ^[2]” However, there isonly one observational report on human infection. ^[3] Daneshvar et al. studied 107 humanP. knowlesi malaria cases and found that “all were thrombocytopenic at hospital admission or onthe following day. ^[3]” However, there is no explanation for the pathomechanismof this finding. Also, there is no systematical assessment on the effect of P. knowlesi malaria infection in humans. Hence, it is the topic for further study on coagulation change in human P. knowlesi malaria.

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.121025