{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:00:41Z","timestamp":1791460841469,"version":"4.3.4"},"reference-count":19,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Medicine at the University Health Network"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Pathogens"],"abstract":"<jats:p>Dengue and malaria are common vector-borne tropical diseases and are associated with high morbidity and mortality. Co-infection of dengue and malaria is underestimated due to parsimonious diagnostic approaches once the diagnosis of either is made, particularly using point-of-care assays, such as rapid diagnostic tests (RDTs). We present a case of dengue and Plasmodium vivax co-infection in a returned traveler from an endemic region, in whom the epidemiology and clinical course are highly suggestive of dengue triggering a P. vivax relapse. The literature on the co-occurrence of dengue and malaria in travelers is reviewed, as is the state of knowledge surrounding dengue as a precipitant to relapsing malaria.<\/jats:p>","DOI":"10.3390\/pathogens14100987","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T16:43:54Z","timestamp":1759250634000},"page":"987","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Case of Intercurrent Dengue and Probable Relapsing Plasmodium vivax Malaria in a Returned Traveler to India: Case Report and Literature Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Kumudhavalli","family":"Kavanoor Sridhar","sequence":"first","affiliation":[{"name":"Division of Medical Microbiology, Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0363-3992","authenticated-orcid":false,"given":"Fahad","family":"Buskandar","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, John Hopkins University, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manreet","family":"Dhaliwal","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordane V.","family":"Calloo","sequence":"additional","affiliation":[{"name":"Faculty of Arts and Science, University of Toronto, Toronto, ON M5S 3G3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2720-6944","authenticated-orcid":false,"given":"Andrea K.","family":"Boggild","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada"},{"name":"Tropical Disease Unit, Toronto General Hospital, Toronto, ON M5G 2C4, Canada"},{"name":"Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 3K3, Canada"},{"name":"Office of Access and Outreach, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"262","DOI":"10.4103\/0972-9062.213508","article-title":"Manifestation and outcome of concurrent malaria and dengue infection","volume":"49","author":"Mohapatra","year":"2012","journal-title":"J. Vector Borne Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.4269\/ajtmh.2012.12-0210","article-title":"Clinical profile of concurrent dengue fever and Plasmodium vivax malaria in the Brazilian Amazon: Case series of 11 hospitalized patients","volume":"87","author":"Alexandre","year":"2012","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1186\/1475-2875-11-142","article-title":"Is dengue and malaria co-infection more severe than single infections? A retrospective matched-pair study in French Guiana","volume":"11","author":"Epelboin","year":"2012","journal-title":"Malar. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.jiph.2015.10.019","article-title":"Prevalence of dengue viral and malaria parasitic co-infections in an epidemic district, Angul of Odisha, India: An eco-epidemiological and cross-sectional study for the prospective aspects of public health","volume":"9","author":"Rao","year":"2016","journal-title":"J. Infect. Public Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1016\/j.trstmh.2007.04.017","article-title":"Concurrent dengue and malaria due to Plasmodium falciparum and P. vivax","volume":"101","author":"Kaushik","year":"2007","journal-title":"Trans. R Soc. Trop. Med. Hyg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"101414","DOI":"10.1016\/j.tmaid.2019.04.014","article-title":"Don\u2019t forget co-infections! A case of intercurrent Plasmodium vivax and dengue infection in a traveler to India and the Caribbean","volume":"32","author":"Kariyawasam","year":"2019","journal-title":"Travel Med. Infect. Dis."},{"key":"ref_7","first-page":"25","article-title":"Clinical features, diagnostic techniques and management of dual dengue and malaria infection","volume":"19","author":"Abbasi","year":"2009","journal-title":"J. Coll. Physicians Surg. Pak."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"211","DOI":"10.7883\/yoken.JJID.2006.211","article-title":"Dual infection by dengue virus and Plasmodium vivax in Alappuzha District, Kerala, India","volume":"59","author":"Thangaratham","year":"2006","journal-title":"Jpn. J. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1159\/000479430","article-title":"Concurrent Infection with Plasmodium vivax and the Dengue and Chikungunya Viruses in a Paediatric Patient from New Delhi, India in 2016","volume":"60","author":"Tazeen","year":"2017","journal-title":"Intervirology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1590\/S0037-86822010000500007","article-title":"Concurrent Dengue and malaria in the Amazon region","volume":"43","author":"Lavezzo","year":"2010","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Magalh\u00e3es, B.M.L., Siqueira, A.M., Alexandre, M.A., Souza, M.S., Gimaque, J.B., Bastos, M.S., Figueiredo, R.M., Melo, G.C., Lacerda, M.V., and Mour\u00e3o, M.P. (2014). P. vivax Malaria and Dengue Fever Co-infection: A Cross-Sectional Study in the Brazilian Amazon. PLoS Negl. Trop. Dis., 8.","DOI":"10.1371\/journal.pntd.0003239"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"520181","DOI":"10.1155\/2013\/520181","article-title":"Concurrent infection with dengue and malaria: An unusual presentation","volume":"2013","author":"Mushtaq","year":"2013","journal-title":"Case Rep. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/1475-2875-10-90","article-title":"Activation of the hypnozoite: A part of Plasmodium vivax life cycle and survival","volume":"10","author":"Hulden","year":"2011","journal-title":"Malar. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s11908-021-00768-9","article-title":"Hematologic Parameters of Acute Dengue Fever versus Other Febrile Illnesses in Ambulatory Returned Travelers","volume":"23","author":"Kain","year":"2021","journal-title":"Curr. Infect. Dis. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1186\/1475-2875-13-144","article-title":"Geographical variation in Plasmodium vivax relapse","volume":"13","author":"Battle","year":"2014","journal-title":"Malar. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1912","DOI":"10.1016\/j.jiph.2020.10.009","article-title":"Circulation of dengue virus serotypes in hyperendemic region of New Delhi, India during 2011\u20132017","volume":"13","author":"Islam","year":"2020","journal-title":"J. Infect. Public Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1038\/s43856-023-00378-7","article-title":"Neutralizing antibodies from prior exposure to dengue virus negatively correlate with viremia on re-infection","volume":"3","author":"Anantharaj","year":"2023","journal-title":"Commun. Med."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Ravi, V., Khare, K., Mohite, R., Mishra, P., Halder, S., Shukla, R., Liu, C.S.C., Yadav, A., Soni, J. (2025). Genomic hotspots in the DENV-2 serotype (E, NS4B, and NS5 genes) are associated with dengue disease severity in the endemic region of India. PLoS Negl. Trop. Dis., 19.","DOI":"10.1371\/journal.pntd.0013034"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1056\/NEJMoa021592","article-title":"Delayed onset of malaria--implications for chemoprophylaxis in travelers","volume":"349","author":"Schwartz","year":"2003","journal-title":"N. Engl. J. 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