This report of fatal falciparum malaria emphasizes an unusual but potentially hazardous complication of blood transfusion. To our knowledge this is the first instance of fatal Plasmodium falciparum infection transmitted by this means. The source of infection was an asymptomatic donor who had resided outside an endemic area for more than 30 months. This is the longest interval thus far recorded that falciparum malaria has remained latent before transmission by transfusion.

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