Image Case: Coincident Malaria falciparum and Covid19 Infection in a 27 Years Old Male Student Coming from Central African Republic.

Malaria is a parasitic infection caused  by different plasmodia species ,the most dan- gerous is Plasmodium falciparum, it is transmitted by Anopheles mosquito female that leads to acute life-threatening disease with significant global health threat. Two billion people are at risk of contracting malaria annually, including those in 90 endemic countries and 125 million travelers to these countries. This parasite has a multistage life cycle with characteristic cyclical fevers. With mass treatment programs in endemic areas most people experience rapid resolution of symptoms; however, significant complications may occur. [1]

Coronaviruses are important human and animal pathogens. At the end of 2019, a novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, a city in   the Hubei province of China ,it rapidly spread resulting in an epidemic throughout China, followed by an increasing number of cases in  other countries till pandemic throughout the world. In February 2020, the world Health organization designated the disease Covid-19, which stands for coronavirus disease 2019[2].

A 27 years old male student was admited to fevers hospital by high grade fever, chills and cough. He just arrived to Egypt 5 days before appearance of symptoms coming from Central African Republic to study at Al- Azhar University. In addition to the previously mentioned symptoms, he also complained of headache, anorexia, vomiting and dark colored urine. Upon admission he was feverish (39.5) and laboratory finding revealed slight elevation of total bilirubin (1.3mg/dl) and creatinine level (1,6mg/dl).

Covid 19 PCR test by (nasopharyngeal swab) was done and found to be positive. High resolution CT chest was done .Bilateral small peripheral patches of ground glass opacity(GGO)were found. Thin and thick blood films and giemsa stained were done revealing Plasmodium falciparum ring stages, rapid diagnostic test (RDT) for malaria   was done and found to be positive for Plasmodium falciparum.