Malaria: a masquerader of cytopenias in leukemia
DOI:
https://doi.org/10.18203/2349-3291.ijcp20232887Keywords:
Fever, Cancer, ParasiteAbstract
In developing countries where the prevalence of malaria and cancer are high it can be expected to occur together. 6-year-old male child, a known case of B cell acute lymphoblastic leukemia, on maintenance phase of chemotherapy presented to us with fever. His initial investigations showed no identifiable focus or significant abnormalities. He continued to have high grade fever spikes in spite of stepping up antibiotics. A week after admission he was found to have cytopenias and mild splenomegaly. Peripheral smear and bone marrow aspiration study showed enlarged RBCs infested by Plasmodium vivax. We report this case to make the clinicians aware that malaria can be cause of fever in patients on cancer treatment.
References
Nirmala, Kumar A, Kapoor AK, Lal B, Dutta GP, Swaroop A. Plasmodium falciparum: drug-resistant malaria complicating leukemias and lymphomas in children. Exp Parasitol. 1999;93(1):33-7.
Bansal D, Gautam P, Dubey ML, Marwaha RK. Presumptive treatment for malaria is not justified in children receiving cancer chemotherapy. Pediatr Blood Cancer. 2010;55(6):1108-10.
Taylor CA, Moreira C, Murray MJ. A retrospective study of malaria in pediatric oncology patients in Senegal. J Pediatr Hematol Oncol. 2011;33(5):325-9.
Ramesh V, Venkata NMM, Sankar J. Mixed Malarial Infection with Pancytopenia in a Child with Acute Lymphoblastic Leukemia: An Unusual Presentation. Indian J Med Paediatr Oncol. 2017;38(1):92.
Ladeb S, Ben Abdejlil N, Fakhfakh N, Lakhal A, Belloumi D, Ben Hamed L et al. Plasmodium falciparum infection transmitted by transfusion: A cause of hemophagocytic syndrome after bone marrow tranplantation in a non-endemic country. Transpl Infect Dis. 2018;20(3):e12887.
Rapoport BL, Uys A. Malaria parasitemia associated with febrile neutropenia in African patients undergoing chemotherapy for haematological malignancies: A report of three patients. Chemotherapy. 2008;54:117-9.
Ellis T, Eze E, Raimi-Abraham BT. Malaria and Cancer: a critical review on the established associations and new perspectives. Infect Agent Cancer. 2021;16(1):33.
Kulkarni JD, Singh R, Pramod PS. Not all blast flags in hematology analysers are leukemia-think malaria! Indian J Cancer: 2020;57(4):505-6.