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Case Reports
. 2022 Jul 27;48(1):130.
doi: 10.1186/s13052-022-01311-9.

MIS-C and co-infection with P. vivax and P. falciparum in a child: a clinical conundrum

Michela Scalisi  1 , Salvatore Giordano  1 , Laura Antonella Canduscio  1 , Maria Concetta Failla  1 , Luca Messina  1 , Elisa Sferrazza  1 , Raffaella Rubino  2 , Lucia Siracusa  1 , Veronica Vanella  1 , Antonio Cascio  2 , Claudia Colomba  3   4
Affiliations
Case Reports

MIS-C and co-infection with P. vivax and P. falciparum in a child: a clinical conundrum

Michela Scalisi et al. Ital J Pediatr. .

Abstract

Background: The ongoing Coronavirus Disease 2019 (COVID-19) epidemic represents an unprecedented global health challenge. Many COVID-19 symptoms are similar to symptoms that can occur in other infections. Malaria should always be considered in patients with SARS-CoV-2 infection returning from endemic areas.

Case presentation: We present the first case of multisystem inflammatory syndrome (MIS-C) and Plasmodium vivax-falciparum and SARS-CoV2 coinfection in children. Despite clearance of parassitaemia and a negative COVID-19 nasopharyngeal PCR, the patient's clinical conditions worsened. The World Health Organization (WHO) criteria were used to make the diagnosis of MIS-C. Treatment with intravenous immunoglobulins and methylprednisolone was effective.

Conclusions: This case emphasizes the importance of considering malaria diagnosis in patients returning from endemic areas, even in the COVID 19 era. Malaria and SARS-CoV2 co-infection may increase the risk of MIS-C, for which early detection is critical for proper management.

Keywords: COVID-19; Case report; Malaria; Multisystem inflammatory syndrome; SARS CoV2.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a. Trofozoite falciparum revealed at thin smear; b. Trofozoite falciparum revealed at thick blood smear; c. Schizonte vivax revealed at thin smear
Fig. 2
Fig. 2
Chest X-ray. Hypo transparency of the right lung fields with accentuation of micronodular reticular pulmonary character pattern, especially on the right side
Fig. 3
Fig. 3
Abdomen ultrasound. Hepatomegaly with starry sky appearance, pelvic intraperitoneal fluid
See this image and copyright information in PMC

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