Gautam Arun, Aryal Ujjwal, Bhandari Sudeep, Pradhan Saugat, Bhattarai Urza, Mishra Akshat, Sharma Sanjib Kumar
Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan 56700, Nepal.
Microbiology, B.P. Koirala institute of Health sciences, Dharan 56700, Nepal.
Oxf Med Case Reports. 2022 Mar 16;2022(3):omac022. doi: 10.1093/omcr/omac022. eCollection 2022 Mar.
A 21-year-old male from Nepal, with a history of travel to Mumbai 2 months ago, presented with fever with chills and rigors, vomiting and multiple joint pain for 1 week. Clinical examination was noteworthy for tachycardia, hypotension and positive tourniquet test. Lab reports showed NS1-Ag positive, thrombocytopenia, lymphocytosis, transaminesemia, hyperbilirubinemia, increased urea and creatinine. He was treated for severe dengue. His laboratory parameters started improving; however, he had fever with chills and rigors daily and persistent vomiting. Repeat peripheral smear for Malaria showed schizonts and trophozoites of Plasmodium vivax. He recovered following treatment with IV fluids and injection artesunate. The presence of fever even in a critical phase of dengue, the typical rise of temperature daily, and jaundice gave a clue of coinfection with Malaria. On follow-up, after 2 weeks, he had no symptoms, and all the laboratory parameters were normal.
一名来自尼泊尔的21岁男性，2个月前有前往孟买的旅行史，出现发热伴寒战和抽搐、呕吐及多关节疼痛1周。临床检查发现心动过速、低血压和束臂试验阳性。实验室报告显示NS1抗原阳性、血小板减少、淋巴细胞增多、转氨酶血症、高胆红素血症、尿素和肌酐升高。他接受了重症登革热治疗。他的实验室指标开始改善；然而，他每天仍有发热伴寒战和抽搐以及持续呕吐。重复进行的疟疾外周血涂片显示有间日疟原虫的裂殖体和滋养体。经静脉补液和注射青蒿琥酯治疗后他康复了。即使在登革热的关键阶段仍有发热、每日典型的体温升高以及黄疸提示合并感染了疟疾。随访2周后，他没有症状，所有实验室指标均正常。
