title: Dengue infection as a potential trigger of an imported Plasmodium ovale malaria relapse or a long incubation period in a non-endemic malaria region.
abstract: OBJECTIVE
  To report that dengue fever (DF) could have triggered Plasmodium ovale wallikeri malaria.
  
  
  METHODS
  A retrospective case report of P. ovale malaria and DF in a single patient in Rio de Janeiro, Brazil, who had lived in Angola, is presented.
  
  
  RESULTS
  On the second week of illness, the patient was referred to our research service. As symptoms had persisted up to day 14, malaria was also considered, based on the patient's long-standing epidemiological history. On day 16 of illness, a thick blood smear was positive for P. ovale (3480 parasites/mm(3)), PCR for malaria was positive for P. ovale wallikeri, and the kinetics of dengue virus (DENV) antibodies suggested a recent primary dengue infection.
  
  
  CONCLUSIONS
  Concurrent infections of DENV and malaria have rarely been reported; the actual impact of these sequential or simultaneous infections remains unknown. Therefore, DF must be considered as a potential co-morbidity for malaria, because of its influence on fluid electrolyte management. The case presented showed consistent temporal, clinical, and laboratory evidence that the relapse or the long incubation period of P. ovale malaria may have been triggered by a recent DF episode. To the authors' knowledge, this is the first report of DENV and P. ovale co-infection.
authors.affiliation: Laboratório de Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (FIOCRUZ), Av. Brasil 4365, CEP 21.040-900, Manguinhos, Rio de Janeiro, RJ, Brazil; Centro de Pesquisa, Diagnóstico e Treinamento em Malária, FIOCRUZ, Rio de Janeiro, RJ, Brazil. Electronic address: otilia.lupi@ini.fiocruz.br.
authors.forename: Otília
authors.initials: O
authors.lastname: Lupi
authors.affiliation: Laboratório de Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (FIOCRUZ), Av. Brasil 4365, CEP 21.040-900, Manguinhos, Rio de Janeiro, RJ, Brazil.
authors.forename: Felipe
authors.initials: F
authors.lastname: Ridolfi
authors.affiliation: Centro de Pesquisa, Diagnóstico e Treinamento em Malária, FIOCRUZ, Rio de Janeiro, RJ, Brazil; Laboratório de Parasitologia, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brazil.
authors.forename: Sidnei
authors.initials: S
authors.lastname: da Silva
authors.affiliation: Centro de Pesquisa, Diagnóstico e Treinamento em Malária, FIOCRUZ, Rio de Janeiro, RJ, Brazil; Laboratório de Parasitologia, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brazil.
authors.forename: Graziela Maria
authors.initials: GM
authors.lastname: Zanini
authors.affiliation: Centro de Pesquisa, Diagnóstico e Treinamento em Malária, FIOCRUZ, Rio de Janeiro, RJ, Brazil; Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz, FIOCRUZ, Pavilhão Leônidas Deane, RJ, Brazil.
authors.forename: Aline
authors.initials: A
authors.lastname: Lavigne
authors.affiliation: Laboratório de Flavivírus, Instituto Oswaldo Cruz, FIOCRUZ, Pavilhão Helio Pereira, Rio de Janeiro, RJ, Brazil.
authors.forename: Rita Maria Ribeiro
authors.initials: RM
authors.lastname: Nogueira
authors.affiliation: Centro de Pesquisa, Diagnóstico e Treinamento em Malária, FIOCRUZ, Rio de Janeiro, RJ, Brazil; Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz, FIOCRUZ, Pavilhão Leônidas Deane, RJ, Brazil.
authors.forename: Maria de Fátima Ferreira
authors.initials: Mde F
authors.lastname: da Cruz
authors.affiliation: Centro de Pesquisa, Diagnóstico e Treinamento em Malária, FIOCRUZ, Rio de Janeiro, RJ, Brazil; Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz, FIOCRUZ, Pavilhão Leônidas Deane, RJ, Brazil.
authors.forename: Cláudio Tadeu
authors.initials: CT
authors.lastname: Daniel-Ribeiro
authors.affiliation: Laboratório de Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (FIOCRUZ), Av. Brasil 4365, CEP 21.040-900, Manguinhos, Rio de Janeiro, RJ, Brazil; Centro de Pesquisa, Diagnóstico e Treinamento em Malária, FIOCRUZ, Rio de Janeiro, RJ, Brazil.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Brasil
mesh_terms: D001938:Brazil; D002908:Chronic Disease; D060085:Coinfection; D015897:Comorbidity; D003715:Dengue / Q000150:complications*; D003716:Dengue Virus; D006801:Humans; D055256:Infectious Disease Incubation Period; D008288:Malaria / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D041122:Plasmodium ovale; D016133:Polymerase Chain Reaction; D012008:Recurrence; D012189:Retrospective Studies
keywords: Co-infection; Dengue; Malaria; Plasmodium ovale wallikeri