FatalPlasmodium falciparum,Clostridium perfringens, andCandida spp.Coinfections in a Traveler to Haiti

Abstract

Malaria is one of the most common causes of febrile illness in travelers. Coinfections with bacterial, viral, and fungal pathogens may not be suspected unless a patient fails to respond to malaria treatment. Using novel immunohistochemical and molecular techniques,Plasmodium falciparum,Clostridium perfringens, andCandida spp.coinfections were confirmed in a German traveler to Haiti.Plasmodium falciparum-induced ischemia may have increased this patient's susceptibility toC. perfringensand disseminated candidiasis leading to his death. When a patient presents withP. falciparumand shock and is unresponsive to malaria treatment, secondary infections should be suspected to initiate appropriate treatment.