International Journal of
Medicine and Medical Sciences

  • Abbreviation: Int. J. Med. Med. Sci.
  • Language: English
  • ISSN: 2006-9723
  • DOI: 10.5897/IJMMS
  • Start Year: 2009
  • Published Articles: 534

Case Report

Mixed Plasmodium falciparum and Plasmodium vivax infection with acute viral hepatitis in two brothers: A rare occurrence

Neeraj Varyani
  • Neeraj Varyani
  • Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh-221005, India.
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Sunny Garg
  • Sunny Garg
  • Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh-221005, India.
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Kamlakar Tripathi
  • Kamlakar Tripathi
  • Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh-221005, India.
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Lalit Prashant Meena
  • Lalit Prashant Meena
  • Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh-221005, India.
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Uma Shankar Rath
  • Uma Shankar Rath
  • Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh-221005, India.
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Sourav Mishra
  • Sourav Mishra
  • Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh-221005, India.
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Garima Gupta
  • Garima Gupta
  • Department of Obstetrics and Gynaecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh-221005, India.
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  •  Accepted: 05 January 2012
  •  Published: 26 January 2012

Abstract

 

Two brothers aged 14 and 17 years presented in our emergency department with complaints of fever and yellowish discoloration of eyes and urine for 6 and 10 days, respectively. They had similar clinical presentation, examination findings, laboratory biochemical derangements and positive results for rapid tests of Plasmodium falciparum and vivax species along with IgMEnzyme-linked immunosorbent assay (ELISA) test for hepatitis A virus. They also showed similar response to therapy and improved simultaneously within two to three days. This suggests the role of immunogenetics in modifying the natural course of disease. Moreover, triple infection by these hepatotropic pathogens lead to a presentation that is much more severe than that caused by either of them alone. This could only be explained by a synergistic interaction between these pathogens. This case foretells that co-infections with two or more hepatotropic pathogens require immediate attention with an aggressive management and role of immunogenetics along with co-infections in altering the phenotypic expression of a disease.

 

Key words: Plasmodium falciparum, Plasmodium vivax, 

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This article is published under the terms of the Creative Commons Attribution License 4.0

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