Abstract
Malaria is an infection caused by five different Plasmodium species. The most common are Plasmodium falciparum and vivax. Plasmodium ovale is more rarely reported and mostly has a benign course. We present a case of a 40-year-old male with a six-day history of headaches, chills, and fever who was initially evaluated in our emergency room, from where he was discharged after a negative workup for malaria. He returned to the hospital five days later in septic shock. Now P. ovale was found in a blood smear. The patient was treated with three doses of intravenous artesunate, followed by a three-day course of oral atovaquone-proguanil. After G6P deficiency and sickle cell tests were found to be negative, he was started on primaquine for 14 days to eradicate liver hypnozoites. The patient had a favorable outcome; the pancytopenia resolved, and he remained stable and was discharged home.