Fever and large pericardial effusion after valve surgery: can be malaria

A 37-year-old man underwent mechanical mitral valve replacement for rheumatic heart disease. One week after discharge, he presented with high-grade fever with chills, malaise, and shortness of breath. Echocardiography showed pericardial effusion with no evidence of vegetation. A blood malaria antigen test was positive for Plasmodium falciparum. One week after initiation of antimalarial medication, echocardiography revealed almost complete resolution of the pericardial effusion. Infective endocarditis is a common cause of fever after valvular heart surgery. Malaria can be considered in the differential diagnosis of fever and pericardial effusion after valvular surgery, especially in malaria-endemic countries