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Erdman LK, Boggild AK, Bitnun A. Imported congenital malaria caused by Plasmodium ovale: A case report. Ther Adv Infect Dis 2024; 11:20499361241229263. [PMID: 38312850 PMCID: PMC10838024 DOI: 10.1177/20499361241229263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/12/2024] [Indexed: 02/06/2024] Open
Abstract
We describe a 5-week-old term infant with Plasmodium ovale severe congenital malaria in a non-endemic setting. She presented with diarrhea, poor feeding, lethargy, hepatosplenomegaly, and severe anemia. She was fortuitously diagnosed with malaria on routine blood smear, and successfully treated with intravenous artesunate. Subsequent history revealed maternal malaria diagnosis and treatment during pregnancy in Nigeria. This case underscores the importance of obtaining maternal exposure history and considering malaria testing in pregnant women and infants with unexplained illness. It also contributes to the limited literature on congenital malaria and severe malaria caused by P. ovale.
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Affiliation(s)
- Laura K. Erdman
- Division of Pediatric Infectious Diseases, McMaster Children’s Hospital, 1200 Main St West, Hamilton, ON L8N 3Z5, Canada
| | - Andrea K. Boggild
- Tropical Disease Unit, University Health Network, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ari Bitnun
- Division of Pediatric Infectious Diseases, Hospital for Sick Children, Toronto, ON, Canada
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Satti Z, Khurshid A, Mohammed R, Jose R, Olayode A. Plasmodium vivax Presenting With Septic Shock and Disseminated Intravascular Coagulation (DIC): A Case Report. Cureus 2023; 15:e40042. [PMID: 37425547 PMCID: PMC10324627 DOI: 10.7759/cureus.40042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Malaria has various causative agents that can have a spectrum of disease manifestations, some potentially fatal. Various species have been established as etiologies of malaria, though our understanding of the severity of various species is changing. We present a unique case of Plasmodium vivax malaria that resulted in severe disease, a magnitude rarely seen in previous literature. Our patient was a 35-year-old healthy woman who presented to the emergency department with abdominal pain, nausea, vomiting, and fever. Further workup revealed severe thrombocytopenia with prolonged prothrombin (PT) and partial thromboplastin time (PTT). An initial thick smear failed to detect any Plasmodium species, but a thin smear revealed P. vivax. The patient's hospital stay was complicated by septic shock requiring intensive care unit (ICU) admission. This unique case represents P. vivax as the causative agent of severe malaria even in healthy, immunocompetent patients.
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Affiliation(s)
- Zain Satti
- School of Medicine, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA
| | - Abaan Khurshid
- School of Medicine, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA
| | - Rahed Mohammed
- Critical Care Medicine, Mount Sinai Queens Hospital, Queens, USA
| | - Rejath Jose
- Internal Medicine, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA
| | - Adewale Olayode
- Critical Care Medicine, Mount Sinai Queens Hospital, Queens, USA
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Biswal D, Mirdha BR. A case of atypical vivax malaria with a global review of reports on myriads of morpho-variations in parasitized red blood cells. Access Microbiol 2023; 5:000461.v3. [PMID: 37223061 PMCID: PMC10202396 DOI: 10.1099/acmi.0.000461.v3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 02/07/2023] [Indexed: 05/25/2023] Open
Abstract
Plasmodium vivax, one of the major species associated with human malaria, continues to be a major public health problem in many parts of the world. Numerous studies related to vivax malaria have described quantitative haematological findings (level of haemoglobin, thrombocytopaenia, haematocrit values), but diverse morphological changes of parasite forms within infected red blood cells (iRBCs) have been mentioned only in few studies. Here we report a case of a 13-year-old boy who presented with fever, significant low platelet counts and hypovolaemia that created a diagnostic dilemma. Detection of microgametocytes by microscopic examinations, further confirmed by multiplex nested PCR assays and response to anti-malarials, helped to make the diagnosis. We present an atypical case of vivax malaria with a review of morpho-variations of iRBCs and have summarized the characteristics that aid in creating increased awareness among laboratory health professionals and public health workers.
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Affiliation(s)
- Debasish Biswal
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Bijay Ranjan Mirdha
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
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de Jesus MCS, Barbosa JHR, Menezes RADO, Gomes MDSM, Bomfim LGS, Pimenta TS, Baptista ARDS, Machado RLD, de Moura TR, Storti-Melo LM. Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and other inflammatory mediators in malaria by Plasmodium vivax during enteroparasites coinfection. PLoS One 2022; 17:e0270007. [PMID: 35749690 PMCID: PMC9232225 DOI: 10.1371/journal.pone.0270007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 06/01/2022] [Indexed: 11/19/2022] Open
Abstract
Malaria is a major health issue with more than 200 million cases occurring annually. Moreover, in Malaria endemic area are frequently observed Malaria-enteroparasite co-infections associated with the modulation of inflammatory response. In this aspect, biomarkers play an important role in the disease prognosis. This study aimed to evaluate inflammatory mediators in malaria during coinfection with enteroparasites. A subset of serum samples already collected was analyzed and divided into four groups: Malaria (n = 34), Co-infected (n = 116), Enteroparasite (n = 120) and Control (n = 95). The serum levels of sTREM-1 and IL-6 were measured by ELISA. TNF-α, and IL-10 levels were previously carried out by flow cytometry. Higher serum levels of sTREM-1 and IL-6 were showed in malaria patients compared to healthy controls. In co-infected malarial patients sTREM-1 serum levels were similar to control group. Interestingly, co-infected malaria patients showed IL-6 serum levels decreased compared to individuals only infected with P. vivax. However, in Malaria patients and co-infected there was a positive correlation between the IL-6 and IL-10 levels (P < 0.0001). This is the first report of sTREM-1 levels in P. vivax infected. Moreover, the results revealing a divergent effect of co-infection with the increased balance between pro-and anti-inflammatory cytokines and reduced IL-6 levels but increases the anemia occurrence. The results also highlight the potential use of IL-6 as a biomarker for P. vivax and enteroparasites coinfection.
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Affiliation(s)
- Myrela Conceição Santos de Jesus
- Programa de Pós-Graduação em Microbiologia e Parasitologia Aplicadas, Instituto Biomédico, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brasil
| | - José Hugo Romão Barbosa
- Programa de Pós-Graduação em Biologia Parasitária, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brasil
| | | | | | | | - Tamirys Simão Pimenta
- Instituto Evandro Chagas / Secretaria de Vigilância em Saúde / Ministério da Saúde, Ananindeua, Pará, Brasil
| | - Andrea Regina de Souza Baptista
- Programa de Pós-Graduação em Microbiologia e Parasitologia Aplicadas, Instituto Biomédico, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brasil
| | - Ricardo Luiz Dantas Machado
- Programa de Pós-Graduação em Microbiologia e Parasitologia Aplicadas, Instituto Biomédico, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brasil
- Programa de Pós-Graduação em Biologia Parasitária, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brasil
| | - Tatiana Rodrigues de Moura
- Programa de Pós-Graduação em Biologia Parasitária, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brasil
- Health Sciences Graduate Program, Federal University of Sergipe, São Cristóvão, Brazil
- Departamento de Morfologia, Centro de Ciências Biológicas e da Saúde, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brasil
- * E-mail:
| | - Luciane Moreno Storti-Melo
- Programa de Pós-Graduação em Biologia Parasitária, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brasil
- Departamento de Biologia, Centro de Ciências Biológicas e da Saúde, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brasil
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Ramirez Ramirez AD, de Jesus MCS, Rossit J, Reis NF, Santos-Filho MC, Sudré AP, de Oliveira-Ferreira J, Baptista ARDS, Storti-Melo LM, Machado RLD. Association of toll-like receptors in malaria susceptibility and immunopathogenesis: A meta-analysis. Heliyon 2022; 8:e09318. [PMID: 35520620 PMCID: PMC9065626 DOI: 10.1016/j.heliyon.2022.e09318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/15/2022] [Accepted: 04/20/2022] [Indexed: 11/25/2022] Open
Abstract
Toll-like receptors (TLRs) play a key role in the induced immune response in malaria. Although the potential roles of TLRs have been described, it is necessary to elucidate which of these receptors may actually have an impact on the immunopathogenesis of the disease. This article performed a meta-analysis adhered to the PRISMA statement on TLRs studied in malaria by Plasmodium falciparum and Plasmodium vivax and its impact on susceptibility and pathogenesis during malaria. A search of the literature was undertaken in PubMed, LILACS and SciELO published until June 30th, 2020. The risk of bias was calculated using the Joanna Briggs Institute's Critical Review Checklist. Later, based on the inclusion and/or exclusion criteria, 17 out of 296 articles were harvested for this systematic review, the meta-analysis included studies incorporating 6,747 cases and 8,983 controls. The results showed that only TLR1, TLR9 and TLR4 receptors were associated with parasitemia, TLR2 and TLR6 were related with severity and none TLR was correlated with susceptibility. The data described here should be taken with caution, since the current evidence is limited and inconsistent. More studies are needed given that the results may change depending on the region and genetic background of the populations.
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Affiliation(s)
- Aína Danaisa Ramirez Ramirez
- Center for Microorganisms' Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Myrela Conceição Santos de Jesus
- Center for Microorganisms' Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
- Laboratory of Molecular Genetics and Biotechnology, Department of Biology, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Júlia Rossit
- Center for Microorganisms' Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Nathália Faria Reis
- Center for Microorganisms' Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Marcelo Cerilo Santos-Filho
- Center for Microorganisms' Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Adriana Pittella Sudré
- Laboratory of Parasites Molecular Biology, Department of Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | | | - Andrea Regina de Souza Baptista
- Center for Microorganisms' Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Luciane Moreno Storti-Melo
- Laboratory of Molecular Genetics and Biotechnology, Department of Biology, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Ricardo Luiz Dantas Machado
- Center for Microorganisms' Investigation, Department of Microbiology and Parasitology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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Kotepui M, Kotepui KU, Milanez GDJ, Masangkay FR. Prevalence and risk factors related to poor outcome of patients with severe Plasmodium vivax infection: a systematic review, meta-analysis, and analysis of case reports. BMC Infect Dis 2020; 20:363. [PMID: 32448216 PMCID: PMC7245863 DOI: 10.1186/s12879-020-05046-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/20/2020] [Indexed: 12/17/2022] Open
Abstract
Background Plasmodium vivax rarely develops severe complications when compared to severe falciparum malaria. However, severe vivax malaria also needs urgent, intensive care and treatment as severe falciparum malaria. This systematic review aimed to explore pooled prevalence of severe vivax malaria and to identify factors related to poor outcome of patients who developed severe manifestation. Methods The systematic review conducted by two reviewers independently through searching of research publications related to severe P. vivax malaria in three databases including MEDLINE, Web of Science (ISI), and Scopus until October, 22 2019. The pooled prevalence of severe vivax malaria was achieved using STATA and RevMan 5 Software. Factors related to poor outcome of patients with severe vivax malaria were analyzed using SPSS 11.5 Software. Results Among 2615 research publications retrieved from three databases, 49 articles reporting on 42,325 severity cases were selected for calculating pooled prevalence. Seventy-six patients from case reports, case series, letter to editors, and research communications were collected to identify factors related to poor outcome of patients with severe vivax malaria. The results showed that severe anemia, jaundice, respiratory distress, impaired consciousness, and renal failure were the most common major manifestations of severe malaria guided by the World Health Organization (WHO) criterion. The meta-analysis indicated that severe malaria was less frequent in patient with P. vivax compared to those with P. falciparum (P -value < 0.00001, OR = 0.38, 95% CI = 0.25–0.56, I2 = 87%). In addition, thrombocytopenia, anemia, hepatitis, and severe thrombocytopenia were the most common minor complications. Analysis of cases indicated that convulsion, respiratory distress, renal failure, jaundice, anuria/oliguria, and complication during treatment impacted on longer hospital stays compared to other severe complications (P-value < 0.05). Respiratory distress was frequently found after first treatment with anti-malarial drugs (P-value = 0.002). Renal failure was frequently found before treatment with anti-malarial drugs (P-value = 0.016). Mean days of fever and higher pulse rates at presentation were predictors of poor outcome among patients with severe vivax malaria (P-value < 0.05). Conclusions Severe anemia was the most common major manifestation of P. vivax malaria guided by the WHO criterion. Severe anemia was found less frequently in patients with P. vivax than those with P. falciparum. Renal failure, jaundice, anuria/oliguria, and complication during treatment along with, mean days of fever and higher pulse rates at presentation might be predictors of poor outcome of patients with severe vivax malaria.
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Affiliation(s)
- Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat, Thailand.
| | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
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Intravenous Artesunate for Imported Severe Malaria in Children Treated in Four Tertiary Care Centers in Germany: A Retrospective Study. Pediatr Infect Dis J 2019; 38:e295-e300. [PMID: 31626041 DOI: 10.1097/inf.0000000000002417] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Intravenous artesunate (ivA) is the standard treatment for severe malaria. Data systematically evaluating the use of ivA in pediatric patients outside malaria-endemic regions are limited. The aim of this case series was to summarize efficacy and safety of ivA for imported severe malaria in children in Germany. METHODS Our retrospective case series included pediatric patients with imported severe malaria treated with at least 1 dose of ivA (Artesun, Guilin Pharmaceutical; Shanghai, China) at 4 German tertiary care centers. Severe malaria was defined according to World Health Organization criteria. RESULTS Between 2010 and 2018, 14 children with a median [interquartile range (IQR)] age of 6 (1;9.5) years were included. All children were of African descent. All but 2 patients had Plasmodium falciparum malaria; 1 child had P. vivax malaria and 1 child had P. falciparum and P. vivax co-infection. Median (IQR) parasitemia at admission in patients with P. falciparum was 9.5% (3;16.5). Patients were treated with 1-10 [median (IQR) 3 (3;4)] doses ivA. All but one patient received a full course of oral antimalarial treatment. Parasite clearance was achieved within 2-4 days, with the exception of 1 patient with prolonged clearance of peripheral parasitemia. Three patients experienced posttreatment hemolysis but none needed blood transfusion. Otherwise ivA was safe and well tolerated. CONCLUSIONS ivA was highly efficacious in this pediatric cohort. We observed episodes of mild to moderate posttreatment hemolysis in approximately one-third of patients. The legal status and usage of potentially lifesaving ivA should be evaluated in Europe.
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Kassegne K, Abe EM, Cui YB, Chen SB, Xu B, Deng WP, Shen HM, Wang Y, Chen JH, Zhou XN. Contribution of Plasmodium immunomics: potential impact for serological testing and surveillance of malaria. Expert Rev Proteomics 2018; 16:117-129. [PMID: 30513025 DOI: 10.1080/14789450.2019.1554441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction: Plasmodium vivax (Pv) and P. knowlesi account together for a considerable share of the global burden of malaria, along with P. falciparum (Pf). However, inaccurate diagnosis and undetectable asymptomatic/submicroscopic malaria infections remain very challenging. Blood-stage antigens involved in either invasion of red blood cells or sequestration/cytoadherence of parasitized erythrocytes have been immunomics-characterized, and are vital for the detection of malaria incidence. Areas covered: We review the recent advances in Plasmodium immunomics to discuss serological markers with potential for specific and sensitive diagnosis of malaria. Insights on alternative use of immunomics to assess malaria prevalence are also highlighted. Finally, we provide practical applications of serological markers as diagnostics, with an emphasis on dot immunogold filtration assay which holds promise for malaria diagnosis and epidemiological surveys. Expert commentary: The approach largely contributes to Pf and Pv research in identifying promising non-orthologous antigens able to detect malaria incidence and to differentiate between past and recent infections. However, further studies to profiling naturally acquired immune responses are expected in order to help discover/validate serological markers of no cross-seroreactivity and guide control interventions. More so, the application of immunomics to knowlesi infections would help validate the recently identified antigens and contribute to the discovery of additional biomarkers of exposure, immunity, or both.
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Affiliation(s)
- Kokouvi Kassegne
- a National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health , National Centre for International Research on Tropical Diseases, WHO Collaborating Center for Tropical Diseases, Shanghai, People's Republic of China
| | - Eniola Michael Abe
- a National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health , National Centre for International Research on Tropical Diseases, WHO Collaborating Center for Tropical Diseases, Shanghai, People's Republic of China
| | - Yan-Bing Cui
- a National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health , National Centre for International Research on Tropical Diseases, WHO Collaborating Center for Tropical Diseases, Shanghai, People's Republic of China
| | - Shen-Bo Chen
- a National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health , National Centre for International Research on Tropical Diseases, WHO Collaborating Center for Tropical Diseases, Shanghai, People's Republic of China
| | - Bin Xu
- a National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health , National Centre for International Research on Tropical Diseases, WHO Collaborating Center for Tropical Diseases, Shanghai, People's Republic of China
| | - Wang-Ping Deng
- a National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health , National Centre for International Research on Tropical Diseases, WHO Collaborating Center for Tropical Diseases, Shanghai, People's Republic of China
| | - Hai-Mo Shen
- a National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health , National Centre for International Research on Tropical Diseases, WHO Collaborating Center for Tropical Diseases, Shanghai, People's Republic of China
| | - Yue Wang
- b Institute of Parasitic Diseases , Zhejiang Academy of Medical Sciences , Hangzhou , People's Republic of China
| | - Jun-Hu Chen
- a National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health , National Centre for International Research on Tropical Diseases, WHO Collaborating Center for Tropical Diseases, Shanghai, People's Republic of China
| | - Xiao-Nong Zhou
- a National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health , National Centre for International Research on Tropical Diseases, WHO Collaborating Center for Tropical Diseases, Shanghai, People's Republic of China
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Gebremeskel Tekle S, Corpolongo A, D'Abramo A, Giancola ML, Iannetta M, Scorzolini L, Marcozzi P, Buffone E, Liuzzi G, Nicastri E. Case Report: Delayed Diagnosis of Congenital Malaria by Plasmodium vivax in a Newborn of an Eritrean Woman with Varicella Infection. Am J Trop Med Hyg 2018; 99:620-622. [PMID: 30014823 DOI: 10.4269/ajtmh.18-0091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Congenital malaria (CM) is uncommon in both malaria-endemic and non-endemic countries. It may be caused by any Plasmodium spp., although Plasmodium falciparum and Plasmodium vivax are the more frequent etiologic agents. We report a case of delayed diagnosis of CM by P. vivax in a newborn of an Eritrean primigravida. The mother developed pregnancy-related immunodepression and varicella-zoster viral infection 9 days before natural delivery; therefore, the child was admitted in the neonatal intensive care unit (NICU) to administer specific varicella-zoster immunoglobulin prophylaxis and for clinical monitoring. During the NICU stay, the newborn presented a febrile syndrome with vomiting, anemia, and thrombocytopenia. A P. vivax severe malaria diagnosis was made by detecting trophozoites in the thick and thin blood smears. The infant was successfully treated with intravenous artesunate and clindamycin. Our experience suggests that malaria diagnostic tests need to be included in routine blood analyses in newborns with febrile syndrome from mothers with an epidemiologic link to malaria-endemic areas.
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Affiliation(s)
| | - Angela Corpolongo
- National Institute of Infectious Diseases IRCCS Lazzaro Spallanzani, Rome, Italy
| | - Alessandra D'Abramo
- National Institute of Infectious Diseases IRCCS Lazzaro Spallanzani, Rome, Italy
| | | | - Marco Iannetta
- National Institute of Infectious Diseases IRCCS Lazzaro Spallanzani, Rome, Italy
| | - Laura Scorzolini
- National Institute of Infectious Diseases IRCCS Lazzaro Spallanzani, Rome, Italy
| | - Paola Marcozzi
- Department of Neonatology, San Camillo Forlanini Hospital, Rome, Italy
| | - Elsa Buffone
- Department of Neonatology, San Camillo Forlanini Hospital, Rome, Italy
| | - Giuseppina Liuzzi
- National Institute of Infectious Diseases IRCCS Lazzaro Spallanzani, Rome, Italy
| | - Emanuele Nicastri
- National Institute of Infectious Diseases IRCCS Lazzaro Spallanzani, Rome, Italy
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