A 50-year-old man presents with fever 25 days after returning from the Amazon basin, Brazil. He took doxycycline prophylaxis with perfect adherence, i...

Question

A 50-year-old man presents with fever 25 days after returning from the Amazon basin, Brazil. He took doxycycline prophylaxis with perfect adherence, including 4 weeks post-travel. Thick film shows P. vivax. What is the explanation?

Accepted Answer

P. vivax hypnozoites reactivated after the 4-week post-travel doxycycline course ended, as doxycycline does not eliminate hypnozoites

Answer

Doxycycline resistance in P. vivax

Answer

The patient acquired malaria in the UK

Answer

This is actually P. falciparum misidentified as P. vivax

Answer

Doxycycline has no antimalarial activity

uk-dtmh MCQ (SBA): P. vivax Relapse After Doxycycline

A 50-year-old man presents with fever 25 days after returning from the Amazon basin, Brazil. He took doxycycline prophylaxis with perfect adherence, including 4 weeks post-travel. Thick film shows P. vivax. What is the explanation?