Exflagellation in Plasmodium vivax Malaria: Diagnostic Dilemmas and Solutions

Trophozoites gametocytes and Schizonts are the most common developmental stages of Plasmodium vivax found in human blood. Exflagellation of microgametes occurs in mosquitos but not in humans during the life cycle malaria parasite. Exflagellation can occur in collected human blood and may cause diagnostic confusion with organisms such as spirochetes and trypanosomes. We present an unusual case of exfagellation in a six-year-old male patient with exflagellated microgametes, an unusual form of Plasmodium vivax in a human peripheral blood smear that may create diagnostic confusion with organisms such as spirochetes and trypanosomes.