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To the Editor:—
The statement by Patterson, Darling, and Blumenthal in "Acute Melioidosis in a Soldier Home From South Vietnam" (200: 447,1967), "Multiple malarial preparations during fever spikes were negative," underlines the fact that many physicians are unaware of the proper time at which to take malarial smears.The unfortunately common practice of ordering smears for malaria parasites to be taken at the height of the patient's fever no doubt stems from the more acceptable routine of obtaining specimens for bacterial culture at that time. A little reflection will serve to show that this is the worst possible time at which to attempt the demonstration of plasmodia in the blood. Fever in malaria results from the almost simultaneous rupture of multitudes of infected red blood cells, with the liberation of merozoites to initiate a new asexual generation. Blood smears obtained at this time may well be devoid of recognizable parasites,
Markell EK. Melioidosis. JAMA. 1967;201(6):490. doi:10.1001/jama.1967.03130060164026