title: SeverePlasmodium knowlesiwith dengue coinfection.
abstract: We report a case of severePlasmodium knowlesiand dengue coinfection in a previously healthy 59-year-old Malay man who presented with worsening shortness of breath, high-grade fever with chills and rigors, dry cough, myalgia, arthralgia, chest discomfort and poor appetite of 1 week duration. There was a history mosquito fogging around his neighbourhood in his hometown. Further history revealed that he went to a forest in Jeli (northern part of Kelantan) 3 weeks prior to the event. Initially he was treated as severe dengue with plasma leakage complicated with type 1 respiratory failure as evidenced by positive serum NS1-antigen and thrombocytopenia. Blood for malarial parasite (BFMP) was sent for test as there was suspicion of malaria due to persistent thrombocytopenia despite recovering from dengue infection and the presence of a risk factor. The test revealed high count of malaria parasite. Confirmatory PCR identified the parasite to bePlasmodium knowlesiIntravenous artesunate was administered to the patient immediately after acquiring the BFMP result. Severe malaria was complicated with acute kidney injury and septicaemic shock. Fortunately the patient made full recovery and was discharged from the ward after 2 weeks of hospitalisation.
authors.affiliation: Department of Internal Medicine, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia.
authors.forename: Mohd Jazman
authors.initials: MJ
authors.lastname: Che Rahim
authors.affiliation: Department of Internal Medicine, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia.
authors.forename: Nurashikin
authors.identifier: http://orcid.org/0000-0003-2178-6121
authors.initials: N
authors.lastname: Mohammad
authors.affiliation: Department of Internal Medicine, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia.
authors.forename: Alwi Muhd
authors.initials: AM
authors.lastname: Besari
authors.affiliation: Department of Internal Medicine, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia.
authors.forename: Wan Syamimee
authors.initials: WS
authors.lastname: Wan Ghazali
mesh_terms: D058186:Acute Kidney Injury / Q000469:parasitology; D060085:Coinfection / Q000150:complications*; D003715:Dengue / Q000150:complications*; D006801:Humans; D008288:Malaria / Q000150:complications* / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D016790:Plasmodium knowlesi; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000469:parasitology