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Severe Plasmodium knowlesi with dengue coinfection.

Abstract We report a case of severe Plasmodium knowlesi and dengue coinfection in a previously healthy 59-year-old Malay man who presented with worsening shortness of breath, high-grade fever with chills and rigors, dry cough, myalgia, arthralgia, chest discomfort and poor appetite of 1 week duration. There was a history mosquito fogging around his neighbourhood in his hometown. Further history revealed that he went to a forest in Jeli (northern part of Kelantan) 3 weeks prior to the event. Initially he was treated as severe dengue with plasma leakage complicated with type 1 respiratory failure as evidenced by positive serum NS1-antigen and thrombocytopenia. Blood for malarial parasite (BFMP) was sent for test as there was suspicion of malaria due to persistent thrombocytopenia despite recovering from dengue infection and the presence of a risk factor. The test revealed high count of malaria parasite. Confirmatory PCR identified the parasite to be Plasmodium knowlesi Intravenous artesunate was administered to the patient immediately after acquiring the BFMP result. Severe malaria was complicated with acute kidney injury and septicaemic shock. Fortunately the patient made full recovery and was discharged from the ward after 2 weeks of hospitalisation.
PMID
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Authors

Mayor MeshTerms

Plasmodium knowlesi

Keywords
Journal Title bmj case reports
Publication Year Start




PMID- 28219910
OWN - NLM
STAT- MEDLINE
DA  - 20170221
DCOM- 20170310
LR  - 20170310
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 2017
DP  - 2017 Feb 20
TI  - Severe Plasmodium knowlesi with dengue coinfection.
LID - bcr2016218480 [pii]
LID - 10.1136/bcr-2016-218480 [doi]
AB  - We report a case of severe Plasmodium knowlesi and dengue coinfection in a
      previously healthy 59-year-old Malay man who presented with worsening shortness
      of breath, high-grade fever with chills and rigors, dry cough, myalgia,
      arthralgia, chest discomfort and poor appetite of 1 week duration. There was a
      history mosquito fogging around his neighbourhood in his hometown. Further
      history revealed that he went to a forest in Jeli (northern part of Kelantan) 3
      weeks prior to the event. Initially he was treated as severe dengue with plasma
      leakage complicated with type 1 respiratory failure as evidenced by positive
      serum NS1-antigen and thrombocytopenia. Blood for malarial parasite (BFMP) was
      sent for test as there was suspicion of malaria due to persistent
      thrombocytopenia despite recovering from dengue infection and the presence of a
      risk factor. The test revealed high count of malaria parasite. Confirmatory PCR
      identified the parasite to be Plasmodium knowlesi Intravenous artesunate was
      administered to the patient immediately after acquiring the BFMP result. Severe
      malaria was complicated with acute kidney injury and septicaemic shock.
      Fortunately the patient made full recovery and was discharged from the ward after
      2 weeks of hospitalisation.
CI  - 2017 BMJ Publishing Group Ltd.
FAU - Che Rahim, Mohd Jazman
AU  - Che Rahim MJ
AD  - Department of Internal Medicine, Universiti Sains Malaysia, Kubang Kerian, 16150,
      Kelantan, Malaysia.
FAU - Mohammad, Nurashikin
AU  - Mohammad N
AUID- ORCID: http://orcid.org/0000-0003-2178-6121
AD  - Department of Internal Medicine, Universiti Sains Malaysia, Kubang Kerian, 16150,
      Kelantan, Malaysia.
FAU - Besari, Alwi Muhd
AU  - Besari AM
AD  - Department of Internal Medicine, Universiti Sains Malaysia, Kubang Kerian, 16150,
      Kelantan, Malaysia.
FAU - Wan Ghazali, Wan Syamimee
AU  - Wan Ghazali WS
AD  - Department of Internal Medicine, Universiti Sains Malaysia, Kubang Kerian, 16150,
      Kelantan, Malaysia.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20170220
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
SB  - IM
MH  - Acute Kidney Injury/parasitology
MH  - Coinfection/*complications
MH  - Dengue/*complications
MH  - Humans
MH  - Malaria/*complications/parasitology
MH  - Male
MH  - Middle Aged
MH  - *Plasmodium knowlesi
MH  - Severity of Illness Index
MH  - Shock, Septic/parasitology
EDAT- 2017/02/22 06:00
MHDA- 2017/03/11 06:00
CRDT- 2017/02/22 06:00
AID - bcr-2016-218480 [pii]
AID - 10.1136/bcr-2016-218480 [doi]
PST - epublish
SO  - BMJ Case Rep. 2017 Feb 20;2017. pii: bcr2016218480. doi: 10.1136/bcr-2016-218480.

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