HIV Infection Diagnosis in a Late Presenter Patient during a Severe Imported Falciparum Malaria: A Challenging

Eugenia Pistarà; Andrea Marino; Manuela Ceccarelli; Federica Cosentino; Vittoria Moscatt; Maria Gussio; Cristina Micali; Giuseppe Nunnari; Bruno Cacopardo; Benedetto Maurizio Celesia

doi:10.3889/oamjms.2022.8671

Authors

Eugenia Pistarà Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, Messina, Italy
Andrea Marino Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Catania, Catania, Italy; Department of Biomedical and Biotechnological Sciences, Unit of Infectious Diseases, University of Catania, Catania, Italy https://orcid.org/0000-0002-5650-6911
Manuela Ceccarelli Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Catania, Catania, Italy
Federica Cosentino Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, Messina, Italy
Vittoria Moscatt Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, Messina, Italy
Maria Gussio Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Catania, Catania, Italy
Cristina Micali Department of Clinical and Experimental Medicine https://orcid.org/0000-0001-6753-6676
Giuseppe Nunnari Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, Messina, Italy
Bruno Cacopardo Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Catania, Catania, Italy
Benedetto Maurizio Celesia Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Catania, Catania, Italy https://orcid.org/0000-0002-6919-1955

DOI:

https://doi.org/10.3889/oamjms.2022.8671

Keywords:

Malaria, HIV, Malaria/HIV coinfection, Late presenters HIV, Plasmodium falciparum

Abstract

BACKGROUND: Malaria and HIV share the same epidemiological spreading and coinfection may be clinically challenging. In 2019, nearly all malaria cases reported by EU/EEA countries were imported. Severe falciparum malaria is a medical emergency often associated with poor outcome, even when treated with appropriate therapy.

CASE PRESENTATION: Here, we described an unusual case of a late presenter HIV diagnosis made during the management of a severe falciparum malaria in an Italian traveler returning from Nigeria, who did not take antimalaria prophylaxis. Clinical course was complicated by the occurrence of several superinfections caused by deep immunosuppression, and bilateral subsegmental pulmonary embolism.

CONCLUSION: Although critical conditions, malaria prompt diagnosis and treatment, along with HIV diagnosis and the successful treatment of occurred superinfection, resulted in a positive outcome.

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