Congenital cerebral malaria: a masquerader in a neonate

Malaria Journal

Kenneth N. Okeke¹  Emeka S. Edokwe¹  Ezinne I. Nwaneli¹  Chisom A. Nri-ezedi¹  Kenechukwu K. Iloh²  Sylvia T. Echendu³ 

[1] Department of Paediatrics, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria;Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria;Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria;Life International Hospital, Awka, Anambra State, Nigeria;

关键词: Complicated malaria;    Newborn;    Seizures;    Early onset neonatal sepsis;    Neonatal meningitis;   

DOI  :  10.1186/s12936-022-04056-2

来源: Springer

【 摘 要 】

BackgroundCongenital malaria, which is caused by vertical transmission of malaria parasites, is a potentially fatal condition. Despite Africa’s high malaria burden, congenital malaria is not routinely screened for, and thus may go undiagnosed. Malaria, if not treated promptly, can quickly progress to severe forms and result in death. Severe congenital malaria is believed to be uncommon in neonates due to maternal antibodies, fetal haemoglobin, and the placenta’s sieving effect. The majority of reported cases were classified as having severe anaemia. Following a thorough review of the literature, only one case of congenital cerebral malaria (CCM) has been reported, and it was misdiagnosed.Case presentationA 5-day-old Nigerian neonate born to an apparently healthy mother initially displayed characteristics consistent with neonatal sepsis and severe neonatal hyperbilirubinaemia. He quickly developed characteristics consistent with meningitis. Surprisingly, the peripheral blood film revealed evidence of malaria parasites, which was immediately confirmed by Giemsa-stained thick and thin blood film microscopy for malaria. The patient was diagnosed with congenital cerebral malaria. The medication was modified to parenteral artesunate followed by oral artemisinin combination therapy. The neonate recovered fully and had no neurological deficits on follow up.ConclusionBecause CCM and infant meningitis have similar clinical presentations, CCM could be misdiagnosed and lead to death if there isn’t a high index of suspicion.

【 授权许可】

CC BY