The COVID-19 pandemic that attacks the world has made the attention of all medical personnel focused on this disease.
The clinical picture is similar to other infectious diseases such as malaria, dengue, influenza, etc., which often leads to
misdiagnosis. We report the case of a man, 31 years old, with a history of travel and complaints of high fever persisting
for more than 7 days. On physical examination, the temperature was 39-40 C, others were within normal limits. Initial
platelet count was 69 x 103
/µL, leukocytes was 15.52 x 109
/L, CRP was 96 mg/L. The blood smear found Plasmodium
falciparum, and PCR SARS-CoV-2 was positive. Chest X-ray showed pneumonia. Dihydroartemisinin-piperaquine
and primaquine therapies were administered for malaria, as well as favipiravir, azithromycin, and other symptomatic
therapy for COVID-19. Platelets decreased to 38 x 103
/µL while D-dimer level increased (> 20 mg/L). Anticoagulant
was delayed. On monitoring after therapy, the platelets returned to normal, the D-dimer level decreased, and there was
no bleeding. The co-infectious conditions of malaria and COVID-19 should be suspected in patients with suggestive
symptoms and travel history from endemic areas, therefore both examinations should be performed. This co-infection
has the potential to cause hyper inflammation and hypercoagulation and this is associated with a poor prognosis.
Appropriate treatment is needed.