A Mysterious Foe in a Case of Malaria: Rare Case of Coinfection with Review of the Literature

Parvovirus B19 and Plasmodium vivax coinfections are rarely documented. Parvovirus B19 may cause bone-marrow suppression, reticulocytopenia, and anemia in malaria patients. Here, we describe an 11-year-old boy with fever, jaundice, and anemia who was diagnosed with P. vivax and treated with chloroquine. Jaundice and fever subsided, but anemia persisted. A blood smear showed no malarial parasites after the completion of antimalarial treatment. Because of persisting anemia, a bone-marrow aspiration was requested, which revealed erythroid suppression and giant proerythroblast with nuclear inclusions. Parvovirus B19-specific IgM antibodies are also found in peripheral blood. The patient received supportive treatment and red blood cell transfusions. After 3 months, the patient was asymptomatic and had normal blood counts. Any chronic anemia should be examined for parvovirus B19 infection, even in cases of well-known factors of anemia. To the best of our knowledge, this is an index case of P. vivax and parvovirus B19 coinfection.