A clinical report on mixed infection of malaria, dengue and chikungunya from New Delhi, India

Abstract

Arthropod-borne infections like malaria, dengue and chikungunya fever are transmitted by mosquitoes. The present report describes an unusual case of mixed infection with malaria, dengue and chikungunya viruses in a 21 year old male patient from New Delhi, India during monsoon season of 2016. The malarial fever was diagnosed by thin slide microscopy and antigen test. Chikungunya virus IgM was detected in the sample by the card test. Dengue and chikungunya viruses were further confirmed by RT-PCR for CprM and E1 gene respectively. Phylogenetic analysis clustered the study dengue virus serotype 3 sequence in the genotype III. Thus, the mono infections can not be differentiated from concurrent infections on the basis of clinical symptoms, the appropriate laboratory diagnosis is essential for the accurate pathogen confirmation. Precise and appropriate identification of the multiple pathogens in such clinical cases will assist in the effective management of these arthropod mediated infections.

Keywords: Case report; Chikungunya virus; Dengue virus; Malaria; Mixed infection.

Fig. 1

Maximum likelihood tree based on the partial sequence of CprM of dengue virus 3. The tree was constructed using Tamura Nei model with 1000 bootstrap value using MEGA 6.0. The analysis involved 25 nucleotide sequences. The study DENV-3 sequence (red color) clustered with Genotype III (color figure online)