Fever in patients with mixed-species malaria.
BACKGROUND
Clinical symptoms of mixed-species malaria infections have been variously reported as both less severe and more severe than those of single-species infections.


METHODS
Oral temperatures were taken from and blood slides were prepared for 2308 adults who presented at outpatient malaria clinics in Tak Province (Thailand) during May-August 1998, May-July 1999, and May-June 2001 with malaria infections diagnosed by 2 expert research microscopists, each of whom was blinded to the other's reports.


RESULTS
In each year, temperatures of patients with mixed Plasmodium vivax-Plasmodium falciparum infections were higher than temperatures of patients with P. vivax or P. falciparum infections. In every mixed-species case, P. falciparum parasitemia was higher than P. vivax parasitemia, but patient temperature was not correlated with the parasitemia of either species or with the total parasitemia.


CONCLUSIONS
Among adults who self-report to malaria clinics in western Thailand, patients with mixed P. vivax-P. falciparum infections have higher fevers than patients with single-species infections, a distinction that cannot be attributed to differences in parasitemia. This observation warrants more detailed investigations, spanning wider ranges of ages and transmission environments.
McKenzie
F Ellis
FE
Fogarty International Center, National Institutes of Health, Bethesda, MD 20892, USA. em225k@nih.gov
Smith
David L
DL
O'Meara
Wendy P
WP
Forney
J Russ
JR
Magill
Alan J
AJ
Permpanich
Barnyen
B
Erhart
Laura M
LM
Sirichaisinthop
Jeeraphat
J
Wongsrichanalai
Chansuda
C
Gasser
Robert A
RA
D000328:Adult; D000818:Animals; D005260:Female; D005334:Fever / Q000469:parasitology*; D006801:Humans; D008288:Malaria / Q000469:parasitology*; D008297:Male; D010963:Plasmodium falciparum; D010966:Plasmodium vivax