title: Fever in patients with mixed-species malaria.
abstract: 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.
authors.affiliation: Fogarty International Center, National Institutes of Health, Bethesda, MD 20892, USA. em225k@nih.gov
authors.forename: F Ellis
authors.initials: FE
authors.lastname: McKenzie
authors.forename: David L
authors.initials: DL
authors.lastname: Smith
authors.forename: Wendy P
authors.initials: WP
authors.lastname: O'Meara
authors.forename: J Russ
authors.initials: JR
authors.lastname: Forney
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Magill
authors.forename: Barnyen
authors.initials: B
authors.lastname: Permpanich
authors.forename: Laura M
authors.initials: LM
authors.lastname: Erhart
authors.forename: Jeeraphat
authors.initials: J
authors.lastname: Sirichaisinthop
authors.forename: Chansuda
authors.initials: C
authors.lastname: Wongsrichanalai
authors.forename: Robert A
authors.initials: RA
authors.lastname: Gasser
mesh_terms: D000328:Adult; D000818:Animals; D005260:Female; D005334:Fever / Q000469:parasitology*; D006801:Humans; D008288:Malaria / Q000469:parasitology*; D008297:Male; D010963:Plasmodium falciparum; D010966:Plasmodium vivax