Dicle BIRTANE, Tuba KAPLAN, Zafer ÇUKUROVA, Habip GEDIK, Gülsüm Oya HERGÜNSEL
Türk Yoğun Bakım Dergisi - 2026;24(2):141-146
Objective: A rare case of coinfection of Plasmodium falciparum and Aspergillus Fumigatus from travel to Tanzania is presented in this report. Methods: A-43-year-old, Turkish male patient who travelled to Tanzania for business without any malaria prophylaxis was admitted to hospital with high fever (39.5 degrees C), weakness, nausea and vomiting and dyspnea when returned to Turkey. The patient had been treated in intensive care unite for sepsis and multi organ dysfunction as a result of the delayed malaria diagnosis. In addition to the presence of thrombocytopenia, anemia, metabolic acidosis, acute respiratory distress syndrome, hepatosplenomegaly and acute renal failure, aspergillus fumigatus emerged as a secondary opportunistic infection. Consent was obtained from the patient's family to publish and all patient specific information has been identified, as a case report and negligible risk to the patient; formal ethics approval was not required because it posed negligible risk to the patient. Results: He was treated with therapeutic plasma exchange seven times, prone position for 36 hours, continued renal replacement therapy for 72 hours, three cycles of artesunate, artemether lumefantrine for three days, with clindamycin and doxycycline. Additionally, meropenem for empirical antibiotherapy, and voriconazole and amphotericin b for Aspergillus were used. Conclusion: This case report showed that malaria should be suspected in patients with febrile illness and that travel history to a malaria-endemic region and when fever recurs during the treatment process, secondary opportunistic infections should be considered in addition to malaria. Pulmonary aspergillosis can be seen in people with supressed immune systems and should also be considered in patients with plasmodium falciparum. Since it has been shown that complications may continue even after the parasite load is eliminated, the addition of extracorporeal treatments to antimalarial therapy may be effective in reducing mortality.
