Injured travelers as well as medical tourists are directly concerned by this strategy. This article has been kindly proofread by Amy Whereat, Medical English Consultant. The authors state they have no conflicts of interest to declare. “
“A 34-year-old Nigerian man presented with nephrotic syndrome. Renal biopsy revealed chronic membranous glomerulopathy with focal segmental sclerosis. Blood Giemsa smear contained rare Plasmodium sp. trophozoites and small subunit

ribosomal RNA polymerase chain reaction amplification confirmed the presence of Plasmodium malariae. This case highlights the importance of obtaining even remote travel histories from ill immigrants and considering occult quartan malaria in patients from endemic locations with nephrotic syndrome. Although quartan Linsitinib mw malaria comprises only a small portion of the global disease burden from malaria, Plasmodium http://www.selleckchem.com/products/Metformin-hydrochloride(Glucophage).html malariae is unique among the plasmodia in which subclinical parasitemia may persist for decades with illness occurring more than 40 years after the last possible exposure.1 Additionally, chronic P malariae infection was linked to nephrotic syndrome in children in the 1960s and subsequently attributed to immune complex basement membrane nephropathy.2,3 We describe a case of P malariae-associated chronic membranous glomerulopathy and nephrotic

syndrome in a US Navy sailor 14 years after his last possible exposure to the risk of malaria. This case highlights the importance of obtaining remote travel histories from Amrubicin immigrants presenting with illness, even decades after emigration from their country of origin. A 34-year-old US-born African American Navy sailor, who moved to Nigeria at the age of 1, migrated back to the United

States at the age of 21 and had not traveled home or to any malaria endemic locations during the ensuing 14 years. While at sea, he presented to his ship’s medical doctor with a 4-month history of bilateral lower extremity pitting edema and swelling of his face and a 5-month history of frothy urine. He was notably hypertensive with hyperlipidemia (total cholesterol 390 mg/dL, low density lipoprotein 305 mg/dL, triglycerides 230 mg/dL) and was placed on hydrochlorothiazide and simvastatin. Upon return to port, the patient was referred to Internal Medicine for suspected nephrotic syndrome. His past medical history was significant for sickle trait, treated latent tuberculosis, and childhood malaria. He denied a family or personal history of kidney disease. Laboratory studies were significant for a spot protein/creatinine ratio of 22.6, consistent with nephrotic syndrome. Additional abnormal laboratory findings included low serum albumin (1.8 g/dL), high serum creatinine (6.2 mg/dL), and a low glomerular filtration rate (14 mL/min).