Journal Article

Fever in Patients with Mixed-Species Malaria

F. Ellis McKenzie, David L. Smith, Wendy P. O'Meara, J. Russ Forney, Alan J. Magill, Barnyen Permpanich, Laura M. Erhart, Jeeraphat Sirichaisinthop, Chansuda Wongsrichanalai and Robert A. Gasser

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 42, issue 12, pages 1713-1718
Published in print June 2006 | ISSN: 1058-4838
Published online June 2006 | e-ISSN: 1537-6591 | DOI:
Fever in Patients with Mixed-Species Malaria

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Background. Clinical symptoms of mixed-species malaria infections have been variously reported as both less severe and more severe than those of single-species infections.

Methods. Oral temperatures were taken from and blood slides were prepared for 2308 adults who presented at outpatient malaria clinics in Tak Province (Thailand) during May–August 1998, May–July 1999, and May–June 2001 with malaria infections diagnosed by 2 expert research microscopists, each of whom was blinded to the other's reports.

Results. In each year, temperatures of patients with mixed Plasmodium vivaxPlasmodium falciparum infections were higher than temperatures of patients with P. vivax or P. falciparum infections. In every mixed-species case, P. falciparum parasitemia was higher than P. vivax parasitemia, but patient temperature was not correlated with the parasitemia of either species or with the total parasitemia.

Conclusions. Among adults who self-report to malaria clinics in western Thailand, patients with mixed P. vivax—P. falciparum infections have higher fevers than patients with single-species infections, a distinction that cannot be attributed to differences in parasitemia. This observation warrants more detailed investigations, spanning wider ranges of ages and transmission environments.

Journal Article.  4487 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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