A thirty one year old man with co-infection of malaria and dengue

Malaria and dengue are two important mosquito borne diseases.
Only imported malaria cases are currently seen in Sri Lanka, mostly from India and Africa. Co-infections with malaria and dengue have not been reported previously in Sri Lanka. A 31-year-old male who had returned from Mozambique 4 weeks before was admitted with a low grade fever for 4 days and diagnosed as dengue fever. After 5 days the fever became high grade and intermittent with chills and rigors. His blood film and antigen test were positive for P. falciparum. Antimalarial treatment was started with intravenous artesunate, followed by artemisinin based combination therapy. The patient’s fever improved with 24 hours of treatment and thereafter he recovered completely. Although co-infections are uncommon, malaria should be considered in any febrile patient with a travel history up to 1 year to a malaria endemic country, even if chemoprophylaxis is taken. Diagnosis of one infection should not exclude the possibility of a coexisting malarial infection in patients with an appropriate travel history, since missing the diagnosis can lead to severe consequences.