Hemophagocytic syndrome associated with severe Plasmodium vivax malaria in a child in Bikaner (northwestern India).

order of the mononuclear phagocytic system, characterized by benign, generalized histiocytic proliferation, with marked hemophagocytosis in bone marrow1. Generally, HPS has been related with hematologic diseases, autoimmune diseases, or with various infections1. There are plenty of reports on hemophagocytic syndrome associated with Plasmodium falciparum monoinfetion2–9, but reports on the association with P. vivax monoinfection are very scanty9–14. In most of these case reports, the diagnosis was made by peripheral blood smear (PBS) and rapid diagnostic test (RDT) without molecular diagnostic confirmation. Thus, there are always chances of species misidentification and missing the mixed infection thereby lacking authenticity. In this case report, the species diagnosis was confirmed by polymerase chain reaction (PCR) and possibilities of other diseases were ruled out by stringent laboratory and biochemical investigations to establish the firm association of hemophagocytic syndrome with P. vivax monoinfection.