Concurrent Infection of Dengue and Malaria: An Unusual Case Report
Abstract
Plasmodium knowlesi is one of the most common causes of Malaria in humans. Although several reported cases of dengue and Malaria occur together, only a few cases have been reported in Southeast Asia, including Indonesia. This study aims to provide additional insight into the epidemiology and clinical aspects of Plasmodium knowlesi (P. knowlesi) malaria infection and dengue fever that occur concurrently in Southeast Asia, particularly Indonesia. A 36-year-old male patient with a history of travel to the mountainous area of Lhoknga and a fever for five days sought treatment at the emergency department of Meuraxa Hospital. During 11 days of treatment, the patient underwent a routine haematology examination every 24 hours. The average platelet count during the first eight days was around 50,000, with an increase after anti-malarial treatment on the eighth day and marked clinical improvement. The patient was discharged on day 10 with no signs of bleeding or hemolysis during treatment. Diagnosis involved blood smears and hematologic examination, confirming dengue fever with P. knowlesi malaria infection. These findings emphasize the importance of thorough history taking, physical examination, and supporting investigations to diagnose these two conditions together. The results of this study may provide critical support for case management involving malaria infection and dengue fever, with a focus on platelet monitoring as an indicator of response to treatment in the Southeast Asian region.
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References
Balaji, S., Deshmukh, R., & Trivedi, V. (2020). Severe Malaria: Biology, clinical manifestation, pathogenesis and consequences. Journal of Vector-Borne Diseases, 57(1), 1.
Chawla, P., Yadav, A., & Chawla, V. (2014). Clinical implications and treatment of dengue. Asian Pacific Journal of Tropical Medicine, 7(3), 169–178.
Daneshvar, C., William, T., & Davis, T. M. E. (2018). Clinical features and management of Plasmodium knowlesi infections in humans. Parasitology, 145(1), 18–31.
Garg, R. K., Malhotra, H. S., & Kumar, N. (2016). Pathophysiology of acute disseminated encephalomyelitis. In Multiple Sclerosis (pp. 201–248). Elsevier.
Kotepui, M., Kotepui, K. U., Milanez, G. D. J., & Masangkay, F. R. (2020). Prevalence of and risk factors for severe Malaria caused by Plasmodium and dengue virus coinfection: A systematic review and meta-analysis. Infectious Diseases of Poverty, 9(1), 1–14.
Lee, K.-S., & Vythilingam, I. (2013). Plasmodium knowlesi: Emergent human Malaria in Southeast Asia. Parasites and Their Vectors: A Special Focus on Southeast Asia, 5–31.
Magalhães, B. M. L., Siqueira, A. M., Alexandre, M. A. A., Souza, M. S., Gimaque, J. B., Bastos, M. S., Figueiredo, R. M. P., Melo, G. C., Lacerda, M. V. G., & Mourão, M. P. G. (2014). P. vivax malaria and dengue fever coinfection: a cross-sectional study in the Brazilian Amazon. PLoS Neglected Tropical Diseases, 8(10), e3239.
Miri, N. F., Mawak, J. D., Chukwu, C. O., Chuwang, N. J., Acheng, S. Y., & Ezekiel, T. (2021). Detection of IgM and IgG Dengue antibodies in febrile patients suspected of Malaria attending health centre in Jos, Nigeria. Annals of Medical Laboratory Science, 1(1), 27–35.
Mushtaq, M. Bin, Qadri, M. I., & Rashid, A. (2013). Concurrent infection with dengue and Malaria: an unusual presentation. Case Reports in Medicine, 2013.
Nelwan, R. H. H., & Subbagian, A. (2013). Malaria plasmodium knowlesi. Cermin Dunia Kedokteran, 204, 327–329.
Ompusunggu, S., Dewi, R. M., Yuliawaty, R., Sihite, B. A., Ekowatiningsih, R., Siswantoro, H., & Siswanto, B. S. U. (2015). Penemuan baru Plasmodium knowlesi pada manusia di Kalimantan Tengah. Bul Penelit Kesehat, 43(2), 63–76.
Sahu, P. S., Sahu, M., & Ambu, S. (2016). A review of concurrent infections of Malaria and dengue in Asia. Asian Pacific Journal of Tropical Biomedicine, 6(7), 633–638.
Sato, S. (2021). Plasmodium—a brief introduction to the parasites causing human Malaria and their basic biology. Journal of Physiological Anthropology, 40(1), 1–13.
Sedger, L. M., & McDermott, M. F. (2014). TNF and TNF-receptors: From cell death and inflammation mediators to therapeutic giants–past, present and future. Cytokine & Growth Factor Reviews, 25(4), 453–472.
Shah, P. D., & Mehta, T. K. (2017). Evaluation of concurrent malaria and dengue infections among febrile patients. Indian Journal of Medical Microbiology, 35(3), 402–405.
Singh, B., & Daneshvar, C. (2013). Human infections and detection of Plasmodium knowlesi. Clinical Microbiology Reviews, 26(2), 165–184.
Tejo, A. M., Hamasaki, D. T., Menezes, L. M., & Ho, Y.-L. (2023). Severe dengue in the intensive care unit. Journal of Intensive Medicine.
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