RESUMO
Malaria is known to be a significant risk factor and also a potential complicating factor during the treatment of lymphoid malignancy. There has not been a reported case of malaria reactivation that occurred weeks after cytotoxic chemotherapy completion, especially in non-endemic regions. Our patient was a 47-year-old man with a history of repeated falciparum malaria infection experiencing 2 months of progressive unilateral nasal blockage and recurrent anterior epistaxis, which was diagnosed as diffuse large B-cell lymphoma (DLBCL) through pathological examination. He was treated with six cycles of classical R-CHOP, resulting in complete remission. One month after remission, he experienced shivering, fever, sweating, and a return to normal temperature, which repeated irregularly for roughly 1 week. His laboratory result showed anaemia, leucopenia, and profound thrombocytopenia. Immunochromatographic testing (ICT) confirmed the diagnosis of falciparum malaria. This case was considered a relapse since our centre is not in the malaria-endemic region. He was cured with a combination of dihydroartemisinin-piperaquine and primaquine. Our case demonstrated the duality of malaria as potential aetiology and treatment complicating factor in DLBCL.
RESUMO
Acute renal failure associated with Plasmodium falciparum infection is already well recognized. Nevertheless, end-stage chronic renal failure and falciparum malaria comorbidity is a rare condition. We report a case of Plasmodium falciparum infection in a young male Javanese patient with end-stage chronic renal failure who underwent regular hemodialysis. This rare comorbidity led to rapid deterioration of consciousness and metabolic disturbances which had already existed in end-stage renal failure. Because of the immunosuppressive condition due to organ failure, the patient did not survive despite anti-malarial chemotherapy.
