Case Report: Severe Plasmodium vivax Malaria Mimicking Sepsis in a Neonate

Suryadi N. N. Tatura Pediatric Infectious and Tropical Disease Division, Department of Pediatrics, Faculty of Medicine, Prof. Dr. R. D. Kandou General Hospital, Manado, Indonesia;
Infectious and Tropical Disease Division, Faculty of Medicine, Department of Pediatrics, Sam Ratulangi University, Manado, Indonesia;
Indonesian National Expert Committee of Malaria, Ministry of Health, Jakarta, Republic of Indonesia;

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Elizabeth Clarissa Wowor Pediatric Infectious and Tropical Disease Division, Department of Pediatrics, Faculty of Medicine, Prof. Dr. R. D. Kandou General Hospital, Manado, Indonesia;

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Jose M. Mandei Emergency and Intensive Care Division, Department of Pediatrics, Prof. Dr. R. D. Kandou General Hospital, Manado, Indonesia;

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Rocky Wilar Neonatology Division, Department of Pediatrics, Prof. Dr. R. D. Kandou General Hospital, Manado, Indonesia;

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Sarah M. Warouw Gastroenterology and Hepatology Division, Department of Pediatrics, Prof. Dr. R. D. Kandou General Hospital, Manado, Indonesia;

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Johnny Rompis Neonatology Division, Department of Pediatrics, Prof. Dr. R. D. Kandou General Hospital, Manado, Indonesia;

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Priscilla Kalensang Pediatric Infectious and Tropical Disease Division, Department of Pediatrics, Faculty of Medicine, Prof. Dr. R. D. Kandou General Hospital, Manado, Indonesia;

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Joseph Tuda Department of Clinical Parasitology, Faculty of Medicine, Prof. Dr. R. D. Kandou General Hospital, Manado, Indonesia

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DOI:
https://doi.org/10.4269/ajtmh.17-0739
Volume/Issue:
Volume 98: Issue 3
Page(s):
656–659
Restricted access
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Severe congenital malaria associated with Plasmodium vivax is uncommon. In Indonesia, most congenital malaria cases are due to Plasmodium falciparum infections. Most cases of congenital or neonatal malaria in endemic areas are diagnosed from peripheral smear as part of routine sepsis workup. Differentiating congenital and acquired neonatal malaria is very difficult. The case presented in this study describes severe P. vivax malaria with cholestatic jaundice and sepsis-like signs and symptoms in neonates. The mother was asymptomatic and the neonate was successfully treated with intravenous artesunate. Severe P. vivax malaria with cholestatic jaundice in neonates is an uncommon condition that should be included in the differential diagnosis of infants displaying hemolytic anemia, thrombocytopenia, cholestatic jaundice, and hepatosplenomegaly in malaria-endemic zones. Early diagnosis can prevent the use of unnecessary antibiotics and mortality of neonates.

Author Notes

Address correspondence to Suryadi N. N. Tatura, Pediatric Infectious and Tropical Disease Division, Department of Pediatrics, Faculty of Medicine, Prof. Dr. R. D. Kandou General Hospital, Sam Ratulangi University, Tanawangko Street 56, Malalayang I, Manado, Indonesia. E-mail: nicolae_n_sur@yahoo.co.id

Financial support: This work was supported by the Department of Child Health, Prof. Dr. R. D Kandou General Hospital, Medical Faculty of Sam Ratulangi University, Manado, North Sulawesi, Indonesia.

Authors’ addresses: Suryadi N. N. Tatura, Pediatric Infectious and Tropical Disease Division, Department of Pediatrics, Faculty of Medicine, Prof. Dr. R. D. Kandou General Hospital, Manado, Indonesia, Infectious and Tropical Disease Division, Department of Pediatrics, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia, and Indonesian National Expert Committee of Malaria, Ministry of Health, Republic of Indonesia, E-mail: nicolae_n_sur@yahoo.co.id. Elizabeth Clarissa Wowor and Priscilla Kalensang, Pediatric Infectious and Tropical Disease Division, Department of Pediatrics, Faculty of Medicine, Prof. Dr. R. D. Kandou General Hospital, Manado, Indonesia, E-mails: elizabeth.wowor@gmail.com and priscillacantia@yahoo.co.id. Jose M. Mandei, Emergency and Intensive Care Division, Department of Pediatrics, Prof. Dr. R. D. Kandou General Hospital, Manado, Indonesia, E-mail: mandeijose.81371@gmail.com. Rocky Wilar and Johnny Rompis, Neonatology Division, Department of Pediatrics, Prof. Dr. R. D. Kandou General Hospital, Manado, Indonesia, E-mails: rocky_wilar@yahoo.com and albmalon@yahoo.com. Sarah M. Warouw, Gastroenterology and Hepatology Division, Department of Pediatrics, Prof. Dr. R. D. Kandou General Hospital, Manado, Indonesia, Indonesia, E-mail: sarahwarouw2002@yahoo.com. Joseph Tuda, Department of Clinical Parasitology, Faculty of Medicine, Prof. Dr. R. D. Kandou General Hospital, Manado, Indonesia, E-mail: jsbtuda@yahoo.com.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2018
Received:
21 Sep 2017
|
Accepted:
19 Nov 2017
|
Published Online:
08 Jan 2018
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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