A case of atypical vivax malaria with a global review of reports on myriads of morpho-variations in parasitized red blood cells.

Abstract: Plasmodium vivax (P.vivax ), one of the major species of human malaria continues to be a major public health problem in many parts of the world. Numerous studies related to vivax malaria have described the quantitative haematological findings (level of haemoglobin, thrombocytopenia, haematocrit values), however, diverse morphological changes of parasite forms within  infected red blood cells (iRBCs) have been mentioned only in few studies.  Here we report a case of 13-year–old boy presented with fever, significant low platelet counts, hypovolemia that created diagnostic dilemma. Detection of microgametocytes by microscopic examinations, further confirmed by multiplex nested polymerase chain reaction (PCR) assay  besides response to anti-malarials helped to make  the diagnosis. We present an atypical case of vivax malaria with review of morpho-variations of iRBCs and have summarized the characteristics that aid in creating increased awareness among laboratory health professionals and public health workers.