An unusual presentation of placental malaria: a single persisting nidus of sequestered parasites

SummaryPlacental malaria caused by Plasmodium falciparum is a public health concern in tropical countries. Peripheral blood smears to detect placental malaria are often negative, and recrudescences are common during pregnancy. We performed placental histology on a series of first-time mothers delivering in an area endemic for P falciparum. A single nidus of malaria-infected erythrocytes was identified by placental histology in a single intervillous space from a woman who had no other evidence of peripheral or placental blood parasitemia. This finding suggests ring stage–infected erythrocytes sequester in vivo, or P falciparum can persist as a dormant blood stage form.