FALCIPARUM MALARIA AND DENGUE CO-INFECTION IN A MALAYSIAN RETURNING FROM NIGERIA: A CASE REPORT

Abstract

A 39-year-old Malaysian Indian woman presented with a five-day history of high-grade fever, myalgia, arthralgia, poor oral intake, and diarrhoea. She had recently returned from a trip to Nigeria. Initial blood tests were positive for NS1, Dengue IgM, and IgG. Due to a low index of suspicion, a blood film for malarial parasites (BFMP) was not performed initially. However, her high-grade fever persisted despite the resolution of dengue warning signs. Given her recent travel to a malaria-endemic region, a BFMP was conducted on the eighth day of illness, revealing severe Plasmodium falciparum parasitemia, with a parasite count of 56,430 parasites/µL (asexual forms) and no gametocytes detected. She was treated with intravenous artesunate and discharged in good health after 12 days of hospitalisation. This case underscores the importance of detecting and diagnosing dengue-malaria co-infection in endemic regions to prevent severe complications.