Introduction: Malaria is the most important parasitic infection, which is now spread all over the globe. Malaria INFECTIONS with more than two species, especially PLASMODIUM falciparum and P. vivax, are common, but INFECTIONS with P. malariae and P. falciparum are rare. Case Presentation: A 33-year-old man presented with fever and chills for three days, pancytopenia, and abnormal liver function tests, Peripheral blood smear revealed P. falciparum and P. malariae. After artemisinin-based combination therapy, all of his symptoms subsided. Discussion: Mixed malaria infection is not uncommon, and it needs to be diagnosed and treated effectively in order to control the disease.Travel consultations should be given for all travelers before their trip to endemic countries.

Background: Among the human parasitic diseases, malaria is the main cause of morbidity and mortality. To prevent the high mortality and tracking malaria elimination efforts, a prompt and sensitive diagnosis is essential. This study aimed to compare High-Resolution Melting (HRM) and microscopic methods to diagnose PLASMODIUM falciparum and P. vivax. Methods: Eighty-one blood samples were collected from patients with clinical symptoms who were suspect to malaria in Chabahar district, southeastern Iran and also, from those who were referred to Malaria National Laboratory in the Tehran University of Medical Sciences, Tehran, Iran. Microscopic examination and HRM method were used to the diagnosis of PLASMODIUM parasites simultaneously. Results: Microscopic results revealed 45 positive cases (12 P. falciparum and 33 P. vivax) out of 81 collected samples while according to HRM analysis results 11 and 33 samples were identified as P. falciparum and P. vivax, respectively. HRM analysis also revealed 1 mixed infection of P. falciparum and P. malariae. Conclusion: HRM analysis provides a promising mean for simultaneous detection and discrimination of the PLASMODIUM spp. especially in mixed infection cases.

Mixed malaria INFECTIONS, PLASMODIUM falciparum and P. vivax, are suspected to occur at a greater frequency than is detected by conventional light microscopy. In order to determine the year round pattern of transmission and the frequency of mixed INFECTIONS in malaria endemic area, we carried out a prospective comparison of diagnosis by conventional light microscopy and nested PCR in Chahbahar district, south-eastern part of Iran. Out of 280 Giemsa-stained slides, 158 (56.42%) were identified as having only P. vivax and 89 (31.78%) were P. falciparum infection by microscopy. Only eight slides (2.8%) were interpreted as having mixed P. vivax-P. falciparum INFECTIONS and 25 (8.9%) were negative. Comparing to the microscopy results, the PCR detected 33 more mixed INFECTIONS. These results showed that the number, of mixed INFECTIONS was increased during April to September and reduced after September, although malaria cases with only P. falciparum were increased. The possibility that malaria patients in Chahbahar district may have undetected mixed INFECTIONS during first peak of transmission should be kept in mind because of the specific therapy required both for P. falciparum and for radical cure of P. vivax.