Falciparum malaria in a child from Ghana with neutrophils showing phagocytosis of trophozoites, merozoites and possibly schizont.

Abstract

Malaria remains a significant health threat in tropical and subtropical regions. The immune response to Plasmodium falciparum involves both humoral and cellular components, including phagocytosis by neutrophils. However, observing phagocytosis through light microscopy is uncommon. This report presents a rare case of falciparum malaria in a Ghanaian twin, highlighting intracellular P. falciparum forms in neutrophils. Two 7-year-old male twins from Ghana were admitted with fever, vomiting, and abdominal pain. They tested positive for P. falciparum infection via rapid diagnostic tests and blood smears. Child 1 displayed significant neutrophilia and intracellular parasites, including trophozoites, merozoites, and a potential schizont, within neutrophils. Child 2 showed no phagocytosis but exhibited other signs of systemic inflammation and hemolysis. Both children were treated successfully with piperaquine tetraphosphate/artenimol (Eurartesim®). This case provides rare microscopic evidence of P. falciparum phagocytosis by neutrophils, suggesting prior antibody development in the patient. While the findings highlight the role of phagocytosis in parasite clearance, the absence of similar observations in the second twin raises questions about individual immune responses and genetic factors. Further research is needed to explore the underlying biological mechanisms.