Additionally, although P malariae accounts for less than 2% of imported malaria cases in the United States,17 careful follow-up of such

patients after initial treatment may be necessary to ensure that chronic infection is not established. The authors would like to acknowledge financial support from US Navy, INK 128 cell line Department of Defense. R. H., J. J. F., A. I. S., and J. D. M. are military service members and employees of the US Government. This work was prepared as part of their official duties. Title 17 U.S.C. 105 provides that “Copyright protection under this title is not available for any work of the United States Government.” Title 17 U.S.C. 101 defines HM781-36B clinical trial a US Government work as a work prepared by a military service member or employee of the US Government as part of that person’s official duties. The assertions herein are the views of the authors and do not reflect official policy of the US Department of the Navy or the US Department of Defense. The authors state that they have no conflicts of interest to declare. “
“Chloroquine-resistant Plasmodium vivax (CRPV) infection is emerging as a clinically significant

problem. Detailed travel history is crucial to the management of imported malarial cases. We report a 58-year-old business traveler who returned from Indonesia and experienced relapse due to CRPV. The epidemiology and diagnostic challenges of CRPV for travel medicine clinicians are reviewed. Malaria is a clinically important cause of febrile illness in local populations as well as in travelers in areas with endemic transmission. Among ill travelers seen at GeoSentinel sites who had returned from all destinations and had fever, malaria accounted for 21% of specific causes identified.1 Although Plasmodium falciparum remains the major clinical concern due to severity

of illness and widespread drug resistance, there is growing awareness of the serious morbidity and emerging drug resistance associated with Plasmodium vivax infection.2 Chloroquine-resistant P. vivax (CRPV) was not reported until 1989,3 pentoxifylline and it remains relatively uncommon except in Papua New Guinea and Indonesia. Unless a detailed travel exposure history is obtained, the risk of CRPV may not be recognized among travelers, especially those who are present in countries that are non-endemic for malaria.4,5 We report here a Singaporean permanent resident who acquired CRPV malaria while traveling on business in Indonesia. A 58-year-old Indonesian man developed fever while traveling in Jakarta, Indonesia, during April 17 to 29, 2008. He had resided in Singapore for 10 years and was otherwise healthy. He reported hospitalization in Jakarta with the diagnoses of P.