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Two cases of\n                      <jats:italic>P. vivax<\/jats:italic>\n                      severe malaria occurred in patients with no evident co-morbidity. Interestingly, both cases did not occur at the primary infection but during relapses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentations<\/jats:title>\n                    <jats:p>\n                      Patient 1: A 27-year old male, born in Afghanistan and living in France since 2012, was admitted on August 2015 to the Avicenne hospital because of abdominal pain, intense headache, fever and hypotension. The patient was haemodynamically unstable despite 5\u00a0L of filling solution. A thin blood film showed\n                      <jats:italic>P. vivax<\/jats:italic>\n                      trophozoites within the red blood cells. To take care of the septic shock, the patient was given rapid fluid resuscitation, norepinephrine (0.5\u00a0mg\/h), and intravenous artesunate. Nested polymerase chain reactions of the SSUrRNA gene were negative for\n                      <jats:italic>Plasmodium falciparum<\/jats:italic>\n                      but positive for\n                      <jats:italic>P. vivax.<\/jats:italic>\n                      The patient became apyretic in less than 24H and the parasitaemia was negative at the same time. Patient 2: A 24-year old male, born in Pakistan and living in France, was admitted on August 2016 because of fever, abdominal pain, headache, myalgia, and nausea. The last travel of the patient in a malaria endemic area occurred in 2013. A thin blood film showed\n                      <jats:italic>P. vivax<\/jats:italic>\n                      trophozoites within the red blood cells. The patient was treated orally by dihydroartemisinin-piperaquine and recovered rapidly. Nine months later, the patient returned to the hospital with a relapse of\n                      <jats:italic>P. vivax<\/jats:italic>\n                      malaria. The malaria episode was uncomplicated and the patient recovered rapidly. Three months later, the patient came back again with a third episode of\n                      <jats:italic>P. vivax<\/jats:italic>\n                      malaria. Following a rapid haemodynamic deterioration, the patient was transferred to the intensive care unit of the hospital. In all the patient received 10\u00a0L of filling solution to manage the septic shock. After 5\u00a0days of hospitalization and a specific treatment, the patient was discharged in good clinical conditions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Clinicians should be aware of the potential severe complications associated with\n                      <jats:italic>P. vivax<\/jats:italic>\n                      in imported malaria, even though the primary infection is uncomplicated.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12936-019-3067-5","type":"journal-article","created":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T13:03:00Z","timestamp":1576501380000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Plasmodium vivax severe imported malaria in two migrants in France"],"prefix":"10.1186","volume":"18","author":[{"given":"Arezki","family":"Izri","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandrine","family":"Cojean","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Leblanc","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yves","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Bouchaud","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1517-8402","authenticated-orcid":false,"given":"R\u00e9my","family":"Durand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2019,12,16]]},"reference":[{"key":"3067_CR1","doi-asserted-by":"publisher","first-page":"e191691","DOI":"10.1001\/jamanetworkopen.2019.1691","volume":"2","author":"E Kendjo","year":"2019","unstructured":"Kendjo E, Houz\u00e9 S, Mouri O, Taieb A, Gay F, Jaur\u00e9guiberry S, et al. 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