Case Report of a Mixed Plasmodium ovale and Plasmodium malariae Malaria Infection in a Returning Patient from Cameroon to Greece with False Negative Malaria Rapid Diagnostic Test

Malaria in a Greek citizen with prior malaria history residing and working in Cameroon returning in his home country is a medical emergency warranting prompt and accurate diagnosis and effective treatment. We describe a mixed malaria case of a febrile patient, a professional returning to Greece from a malaria-endemic country whose initial diagnosis was a false-negative malaria rapid diagnostic test. Subsequent alternative rapid diagnostic test, malaria thin-film blood examination and molecular diagnosis revealed mixed malaria infection from Plasmodium ovale and Plasmodium malariae. The patient was successfully treated and achieved complete clinical recovery. The case described here highlights important points regarding prompt and accurate malaria diagnosis in returning travelers in non-endemic countries, emphasizing the importance of revealing cryptic mixed malaria cases and providing molecular approaches to malaria diagnosis in combination with the gold-standard microscopy.