Fatal Plasmodium falciparum, Clostridium perfringens, and Candida spp. Coinfections in a Traveler to Haiti.pdfVIP

Hindawi Publishing Corporation Journal of Tropical Medicine Volume 2009, Article ID 969070, 6 pages doi:10.1155/2009/969070 Case Report Fatal Plasmodium falciparum, Clostridium perfringens, and Candida spp. Coinfections in a Traveler to Haiti Gillian L. Genrich,1 Julu Bhatnagar,2 Christopher D. Paddock,2 and Sherif R. Zaki2 1 The George Washington University Medical Center, Washington DC 20037, USA 2 Infectious Diseases Pathology Branch, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E., Mailstop G32, Atlanta, GA 30333, USA Correspondence should be addressed to Sherif R. Zaki, szaki@ Received 8 October 2008; Revised 30 January 2009; Accepted 17 March 2009 Recommended by Hans-Peter Beck Malaria is one of the most common causes of febrile illness in travelers. Coinfections with bacterial, viral, and fungal pathogens may not be suspected unless a patient fails to respond to malaria treatment. Using novel immunohistochemical and molecular techniques, Plasmodium falciparum, Clostridium perfringens, and Candida spp. coinfections were confirmed in a German traveler to Haiti. Plasmodium falciparum-induced ischemia may have increased this patient’s susceptibility to C. perfringens and disseminated candidiasis leading to his death. When a patient presents with P. falciparum and shock and is unresponsive to malaria treatment, secondary infections should be suspected to initiate appropriate treatment. Copyright © 2009 Gillian L. Genrich et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 1. Introduction