Robert Jakubowski, Lisa L. Steed, Susan E. Dorman, and Camelia Marculescu.
In this case report, we present a case of concomitant malaria and invasive nontyphoidal Salmonella infection in a returning traveler to the U.S. from Nigeria. Malaria was diagnosed by rapid antigen testing, but recognition of invasive nontyphoidal Salmonella disease was delayed. While the moniker, “typhomalaria,” once used to describe an illness with features of malaria and typhoid fever, has fallen out of favor, it may nevertheless be a helpful reminder to clinicians that both infectious diseases can arise in the same patient.
Blood cultures should be obtained routinely in febrile returning travelers from malaria-endemic regions, including those in whom the diagnosis of malaria has already been established. Awareness of the association between malaria and Salmonella bacteremia is important for clinicians. In patients with malaria, undiagnosed Salmonella bacteremia may lead to morbidity due to untreated salmonellosis and/or changes in antimalarial treatment if fevers are incorrectly attributed to malaria drug resistance.
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