Typhoid and malaria co-infection - an interesting finding in the investigation of a tropical Fever.

In the investigation of fever in the tropics, two important diagnoses to be ruled out are typhoid and malaria. Both cause significant morbidity, mortality and economic loss. An estimated 17 million cases of typhoid are reported worldwide each year, resulting in 0.6 million deaths. Seventy five to eighty percent of these cases occur in Asia alone. Malaria affects 1 billion people each year; out of which 1-3 million die. Although caused by very different organisms - one a Gram negative bacilli, the other a protozoa, and transmitted via different mechanisms - ingestion of contaminated food and water and via the bite of an insect vector respectively, both typhoid and malaria share rather similar symptomatology and epidemiology. Malaysia is endemic for both these diseases and one should not be too surprised when faced with a diagnosis of co-infection of typhoid and malaria, as have been described in India and Canada. Here we describe one such case of Salmonella typhi and Plasmodium vivax infection.