A Case of Bilateral Retinal Hemorrhages Caused by Plasmodium Vivax Malaria

ABSTRACT

PURPOSE: To report a case of bilateral retinal hemorrhages caused by Plasmodium vivax malaria. CASE SUMMARY: The 38-year-old male patient with cyclic high fever for 48 hours was admitted to the department of internal medicine in our hospital. He complained of decreased visual acuity of the left eye. The best corrected visual acuity was 1.0 in right eye and 0.3 in left eye. His blood hemoglobin concentration was 7.5 g/dl. Fundus examination revealed retinal hemorrhages in the posterior pole and preretinal hemorrhage in the macular area in his left eye. The peripheral blood smear confirmed Plasmodium vivax malaria. Hydroxychloroquine and Premaquine were given orally. Forty-nine days after the initial visit, retinal hemorrhages in the posterior pole and preretinal hemorrhage in the macula area occurred in his right eye. Although retinal hemorrhages in both eyes were reduced 100 days after the initial visit, the best corrected visual acuity was 0.2 in right eye and 0.4 in left eye and visual acuity did not improve. CONCLUSIONS: Retinal hemorrhages infrequently can occur by Plasmodium viviax malaria and can result in permanent visual loss.