Garcia Marcos, Hindy Joya-Rita, Boustany Antoine, Gopalakrishna K V
Internal Medicine, Cleveland Clinic Fairview Hospital, Cleveland, USA.
Cureus. 2022 Dec 26;14(12):e32969. doi: 10.7759/cureus.32969. eCollection 2022 Dec.
Malaria has been associated with bacterial co-infections, but the importance of bacterial co-infections in uncomplicated malaria is poorly described. We report a unique case of a 27-year-old female with concomitant Plasmodium falciparum and Bacillus cereus bacteremia who acquired those infections while traveling in Tanzania but became ill only after returning to the United States. Blood parasites screen revealed Plasmodium falciparum and blood cultures obtained at presentation showed Bacillus cereus. Even after completing treatment for malaria, she continued to have abdominal pain and watery diarrhea, which improved only after IV vancomycin. Bacillus cereus bacteremia cases are reported in travelers and immigrants returning from countries where malaria transmission occurs, mainly from sub-Saharan Africa but co-infection with Plasmodium falciparum and Bacillus cereus has not been described in the literature yet. In this case, malaria symptoms resolved after targeted treatment was initiated but persistent diarrhea improved only after appropriate therapy against Bacillus cereus. Persistent watery diarrhea and dehydration in patients with malaria should raise concerns about Bacillus cereus co-infection.
疟疾一直与细菌合并感染有关，但在非复杂性疟疾中细菌合并感染的重要性鲜有描述。我们报告了一例独特病例，一名27岁女性同时感染恶性疟原虫和蜡样芽孢杆菌败血症，她在坦桑尼亚旅行时感染了这些病原体，但回到美国后才发病。血液寄生虫筛查发现恶性疟原虫，就诊时采集的血培养显示有蜡样芽孢杆菌。即使完成了疟疾治疗，她仍持续腹痛和水样腹泻，静脉注射万古霉素后症状才有所改善。从疟疾传播地区（主要是撒哈拉以南非洲）返回的旅行者和移民中报告了蜡样芽孢杆菌败血症病例，但恶性疟原虫与蜡样芽孢杆菌的合并感染在文献中尚未见报道。在此病例中，针对性治疗开始后疟疾症状得到缓解，但持续性腹泻在针对蜡样芽孢杆菌进行适当治疗后才有所改善。疟疾患者出现持续性水样腹泻和脱水时应警惕蜡样芽孢杆菌合并感染。
