Tropical turmoil: A battle with malaria and severe dengue co-infection

A 38-year-old male soldier from a tropical forest region in India presented with persistent high-grade fever, jaundice, altered sensorium, and acute kidney injury. Initially diagnosed and managed as severe dengue based on a positive NS1 antigen test, he showed clinical deterioration, prompting further evaluation that confirmed Plasmodium. falciparum infection on peripheral smear. The clinical course was complicated by acute liver injury, thrombocytopaenia, and encephalopathy. He was treated with intravenous artesunate, broad-spectrum antibiotics, N-acetylcysteine, and supportive care. The patient made a full recovery with normalisation of hepatic, renal, and neurological functions. This case highlights the importance of considering dual infections in endemic regions, especially when clinical progression is atypical, and emphasises the need for comprehensive diagnostic workup and timely, multidisciplinary management to improve outcomes.