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Case Report: Delayed Diagnosis of Congenital Malaria by Plasmodium vivax in a Newborn of an Eritrean Woman with Varicella Infection

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  • 1 National Institute of Infectious Diseases IRCCS Lazzaro Spallanzani, Rome, Italy;
  • 2 Department of Neonatology, San Camillo Forlanini Hospital, Rome, Italy

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.

Author Notes

Address correspondence to Alessandra D’Abramo, National Institute of Infectious Diseases IRCCS, Lazzaro Spallanzani, Via Portuense 292, Rome 00149, Italy. E-mail: alessandra.dabramo@inmi.it

Financial support: Publication of this report was supported by Ricerca Corrente and Ricerca finalizzata WFR PE-2013-02357936 funded by the Italian Ministry of Health.

Authors’ addresses: Saba Gebremeskel Tekle, Angela Corpolongo, Alessandra D’Abramo, Maria Letizia Giancola, Marco Iannetta, Laura Scorzolini, Giuseppina Liuzzi, and Emanuele Nicastri, National Institute of Infectious Diseases IRCCS Lazzaro Spallanzani, Rome, Italy, E-mails: saba.gebremeskeltekle@inmi.it, angela.corpolongo@inmi.it, alessandra.dabramo@inmi.it, mletizia.giancola@inmi.it, marco.iannetta@inmi.it, laura.scorzolini@inmi.it, liuzzi@inmi.it, and emanuele.nicastri@inmi.it. Paola Marcozzi and Elsa Buffone, Department of Neonatal ICU, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy, E-mails: pmarcozzi@scamilloforlanini.rm.it and buffone@scamilloforlanini.rm.it.

These authors contributed equally to this work.

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