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The dangers of accepting a single diagnosis: case report of concurrent Plasmodium knowlesi malaria and dengue infection

Overview of attention for article published in Malaria Journal, January 2017
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Title
The dangers of accepting a single diagnosis: case report of concurrent Plasmodium knowlesi malaria and dengue infection
Published in
Malaria Journal, January 2017
DOI 10.1186/s12936-016-1666-y
Pubmed ID
Authors

Soon Eu Chong, Rhendra Hardy Mohamad Zaini, Siti Suraiya, Kok Tong Lee, Jo Anne Lim

Abstract

Dengue and malaria are two common, mosquito-borne infections, which may lead to mortality if not managed properly. Concurrent infections of dengue and malaria are rare due to the different habitats of its vectors and activities of different carrier mosquitoes. The first case reported was in 2005. Since then, several concurrent infections have been reported between the dengue virus (DENV) and the malaria protozoans, Plasmodium falciparum and Plasmodium vivax. Symptoms of each infection may be masked by a simultaneous second infection, resulting in late treatment and severe complications. Plasmodium knowlesi is also a common cause of malaria in Malaysia with one of the highest rates of mortality. This report is one of the earliest in literature of concomitant infection between DENV and P. knowlesi in which a delay in diagnosis had placed a patient in a life-threatening situation. A 59-year old man staying near the Belum-Temengor rainforest at the Malaysia-Thailand border was admitted with fever for 6 days, with respiratory distress. His non-structural protein 1 antigen and Anti-DENV Immunoglobulin M tests were positive. He was treated for severe dengue with compensated shock. Treating the dengue had so distracted the clinicians that a blood film for the malaria parasite was not done. Despite aggressive supportive treatment in the intensive care unit (ICU), the patient had unresolved acidosis as well as multi-organ failure involving respiratory, renal, liver, and haematological systems. It was due to the presentation of shivering in the ICU, that a blood film was done on the second day that revealed the presence of P. knowlesi with a parasite count of 520,000/μL. The patient was subsequently treated with artesunate-doxycycline and made a good recovery after nine days in ICU. This case contributes to the body of literature on co-infection between DENV and P. knowlesi and highlights the clinical consequences, which can be severe. Awareness should be raised among health-care workers on the possibility of dengue-malaria co-infection in this region. Further research is required to determine the real incidence and risk of co-infection in order to improve the management of acute febrile illness.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 53 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 53 100%

Demographic breakdown

Readers by professional status Count As %
Unspecified 11 21%
Student > Master 11 21%
Researcher 8 15%
Student > Bachelor 6 11%
Student > Postgraduate 5 9%
Other 12 23%
Readers by discipline Count As %
Medicine and Dentistry 15 28%
Unspecified 13 25%
Immunology and Microbiology 7 13%
Agricultural and Biological Sciences 5 9%
Biochemistry, Genetics and Molecular Biology 4 8%
Other 9 17%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 January 2017.
All research outputs
#6,746,193
of 8,854,945 outputs
Outputs from Malaria Journal
#2,593
of 3,072 outputs
Outputs of similar age
#213,367
of 301,902 outputs
Outputs of similar age from Malaria Journal
#104
of 118 outputs
Altmetric has tracked 8,854,945 research outputs across all sources so far. This one is in the 13th percentile – i.e., 13% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,072 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.2. This one is in the 9th percentile – i.e., 9% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 301,902 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 17th percentile – i.e., 17% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 118 others from the same source and published within six weeks on either side of this one. This one is in the 10th percentile – i.e., 10% of its contemporaries scored the same or lower than it.