自1974年起台灣已無本土型瘧疾病例報告，所有個案均為境外移入。一位未曾出國旅行的原住民被診斷為合併感染惡性瘧原蟲與間日瘧原蟲。我們發現病人的侄充曾在所羅門群島接觸到上述兩種原蟲，返國後即已產生發燒與原蟲血症。分析病人為一介入型感染個案，臨床表現有不規則熱、肝脾腫大、黃疸、肺水腫與明顯之多重抗藥性現象。所幸後經青蒿琥酯治癒。這位病人未曾出國而致瘧意味著居住區域蟲媒感染的可能性。合併感染急性瘧原蟲與間日瘧原蟲對於治療當中產生抗藥性時藥物的考量也有所差異。

Taiwan has had no cases of autochthonous malaria reported since 1974. All cases since then have been imported. We report a Taiwanese man with no history of travel outside Taiwan who was coinfected with of Plasmodium falciparum and Plasmodium vivax. The only possible source we could discover was a nephew who had contracted both parasites in the Solomon Islands. He had recurrent fever and parasitemia after returning to Taiwan. Our patient might have been infected by disease introduced by his nephew. The clinical course was characterized by an irregular fever pattern, hepa-tosplenomegaly, jaundice, pulmonary edema, and there was apparent multi-drug resistance, but his parasitemia finally resolved with the use of artesunate. This case is particularly important because of a negative travel history, raising the possibility of further autochthonous cases occurring in that area. Also, a co-infection with both P. falciparum and P. vivax raises certain challenges during treatment, as resistance to antimalarial drugs may differ between the two organisms.