Tropical Diseases in Cancer Patients

  • Jorge Enrique Sinclair ÁvilaEmail author
  • Jorge Enrique Sinclair De Frías
  • Felix Liu Wu
Reference work entry


Currently, as the incidence and prevalence of cancer rises, it is not uncommon to find oncologic patients with tropical diseases in endemic areas. Some of these patients will require specialized care from an intensive unit care.

Forty years ago, little was known about oncologic patients with tropical infections. The coexistence was rarely considered having them misdiagnosed with opportunistic infections or complications, thus rendering them to be “terminal” patients.

Nowadays, the paradigm has changed. The cancer patient is highly susceptible to complications with tropical virus diseases, and a high suspicion is necessary for diagnosis and early treatment to avoid mortal complications. Therefore, it is important to consider its coexistence, and medical staff should be trained to have keen eyes for this. Intensive care units should have a special health-care team prepared and dedicated just for these patients.

With the globalization, demographic changes and frequent travels, cancer patients are more susceptible to be infected by tropical diseases, especially with arboviruses whose vector is the mosquito anopheles; leading to hematologic function impairment and raising mortality rate.

In this chapter we will review the etiology, epidemiology, pathophysiology, clinical findings, diagnosis, prognosis, and management of the most relevant infection diseases: malaria, dengue fever, chikungunya fever, Zika, and yellow fever.


Malaria Dengue fever Yellow fever Chikungunya Zika Arbovirus Tropical disease 


  1. 1.
    Bahl A, Bakhshi S. Dengue fever in patients with pediatric malignancy on chemotherapy: a concern in tropical countries. Pediatr Blood Cancer. 2011;57:1249–50. Scholar
  2. 2.
    Barzon L, Trevisan M, Sinigaglia A, Lavezzo E, Palu G. Zika virus: from pathogenesis to disease control. FEMS Microbiol Lett. 2016;363:1–17. Scholar
  3. 3.
    Bhatt S, et al. The global distribution and burden of dengue. Nature. 2013;496:504–7. Scholar
  4. 4.
    Burt FJ, Rolph MS, Rulli NE, Mahalingam S, Heise MT. Chikungunya: a re-emerging virus. Lancet. 2012;379:662–71. Scholar
  5. 5.
    Burt FJ, et al. Chikungunya virus: an update on the biology and pathogenesis of this emerging pathogen. Lancet Infect Dis. 2017;17:e107–17. Scholar
  6. 6.
    CDC. Preparedness and Response for Chikungunya Virus Introduction in the Americas Chikungunya Virus Introduction in the Americas. 2011. Available at:
  7. 7.
    CDC. Treatment of Malaria (Guidelines For Clinicians). 2013. Available at:
  8. 8.
    Cowman AF, Healer J, Marapana D, Marsh K. Malaria: biology and disease. Cell. 2016;167:610–24. Scholar
  9. 9.
    Daneshvar C, William T, Davis TME. Clinical features and management of Plasmodium knowlesi infections in humans. Parasitology. 2018;145:18–31. Scholar
  10. 10.
    Dondorp AM, Pongponratn E, White NJ. Reduced microcirculatory flow in severe falciparum malaria: pathophysiology and electron-microscopic pathology. Acta Trop. 2004;89:309–17. Scholar
  11. 11.
    Fairhurst RM, Wellems TE. Malaria (Plasmodium Species). In: Bennet J, Dolin R, Blaser M, editors. Mandell, Douglas, and Bennet’s principles and practice of infectious disease. Philadelphia: Elsevier; 2015. p. 3070–89.Google Scholar
  12. 12.
    Gardner CL, Ryman KD. Yellow fever: a reemerging threat. Clin Lab Med. 2010;30:237–60. Scholar
  13. 13.
    Gibbs LM, Creech DA. Malaria. In: Kellerman R, Bope E (eds) Conn’s current therapy. 2018.
  14. 14.
    Hadinegoro SR. The revised WHO dengue case classification: does the system need to be modified? Paediatr Int Child Health. 2012;32(Suppl 1):33–8. Scholar
  15. 15.
    Hanson JP, et al. Fluid resuscitation of adults with severe falciparum malaria: effects on acid-base status, renal function, and extravascular lung water. Crit Care Med. 2013;41:972–81. Scholar
  16. 16.
    Hanson J, Anstey NM, Bihari D, White NJ, Day NP, Dondorp AM. The fluid management of adults with severe malaria. Crit Care. 2014;18:642.CrossRefGoogle Scholar
  17. 17.
    Hidalgo JL, Rodriguez G, Woc-Colburn L, Baldisseri M, editors. Fundamental critical care support: tropical disease. USA: Society of Clinical Care Medicine; 2016.Google Scholar
  18. 18.
    Idro R, Jenkins NE, Newton CRJC. Pathogenesis, clinical features, and neurological outcome of cerebral malaria. The Lancet Neurology. 2005;4:827–40. Scholar
  19. 19.
    Kellermann S, Kellerman RD. Zika virus disease. Elsevier. 2018.
  20. 20.
    Kobayashi T, Gamboa D, Ndiaye D, Cui L, Sutton PL, Vinetz JM. Malaria diagnosis across the international centers of excellence for malaria research: platforms, performance, and standardization. Am J Trop Med Hyg. 2015;93:99–109. Scholar
  21. 21.
    Lo Presti A, Lai A, Cella E, Zehender G, Ciccozzi M. Chikungunya virus, epidemiology, clinics and phylogenesis: a review. Asian Pac J Trop Med. 2014;7:925–32. Scholar
  22. 22.
    Monath TP, Vasconcelos PF. Yellow fever. J Clin Virol. 2015;64:160–73. Scholar
  23. 23.
    Noisakrana S, Onlamoona N, Hsiaoa H-M, Clarka KB, Villingera F, Ansaria AA, Pernga GC. Infection of bone marrow cells by dengue virus in vivo: Elsevier; 2012.
  24. 24.
    Pasvol G. The treatment of complicated and severe malaria. Br Med Bull. 2005;75–76:29–47. Scholar
  25. 25.
    Plewes K, Turner GDH, Dondorp AM. Pathophysiology, clinical presentation, and treatment of coma and acute kidney injury complicating falciparum malaria. Curr Opin Infect Dis. 2018;31:69–77. Scholar
  26. 26.
    Simon F, Savini H, Parola P. Chikungunya: a paradigm of emergence and globalization of vector-borne diseases. Med Clin North Am. 2008;92:1323–43, ix. Scholar
  27. 27.
    Simon F, et al. French guidelines for the management of chikungunya (acute and persistent presentations). November 2014. Med Mal Infect. 2015;45:243–63. Scholar
  28. 28.
    Singh N, Sharma RK. Improving diagnosis and treatment of uncomplicated malaria. Lancet Glob Health. 2014;2:e304–5. Scholar
  29. 29.
    Talwar V, Goel V, Raina S, Talwar J, Patnaik N, Doval DC. Dengue fever in cancer patients: retrospective analysis. Current Medicine Research and Practice. 2016;6:157–9. Scholar
  30. 30.
    Tan KR, Wiegand RE, Arguin PM. Exchange transfusion for severe malaria: evidence base and literature review. Clin Infect Dis. 2013;57:923–8. Scholar
  31. 31.
    Thomas SJ, Endy TP, Rothman AL, Barrett AD. Flavivirus. In: Bennet J, Dolin R, Blaser M, editors. Mandell, Douglas, and Bennet’s Principles and Practice of Infectious Disease. Philadelphia: Elsevier; 2015. p. 1881–902.Google Scholar
  32. 32.
    Thwaites GE, Day NP. Approach to fever in the returning traveler. N Engl J Med. 2017;376:548–60. Scholar
  33. 33.
    Visser T, Daily J, Hotte N, Dolkart C, Cunningham J, Yadav P. Rapid diagnostic tests for malaria. Bull World Health Organ. 2015;93:862–6. Scholar
  34. 34.
    White NJ, Pukrittayakamee S, Hien TT, Faiz MA, Mokuolu OA, Dondorp AM. Malaria. Lancet. 2014;383:723–35. Scholar
  35. 35.
    WHO. Guidelines on Clinical Management of Chikungunya Fever. 2008. Available at:
  36. 36.
    WHO. Dengue Guidelines for Diagnosis, Treatment, Prevention and Control. 2009. Available at:
  37. 37.
    WHO. Comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever. Revised and expanded edition. 2011. Available at:
  38. 38.
    WHO. handbook for clinical management of dengue. 2012. Available at:
  39. 39.
    WHO. Guidelines for the Treatment of Malaria. 2015. Available at:
  40. 40.
  41. 42.
    Griffith KS, Lewis LS, Mali S, Praise ME. Treatment of Malaria in the United States: A Systematic Review. JAMA. 2007;297(20):2264–2277.

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Jorge Enrique Sinclair Ávila
    • 1
    Email author
  • Jorge Enrique Sinclair De Frías
    • 1
  • Felix Liu Wu
    • 1
  1. 1.University of PanamaPanama CityPanama

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