Iqtada Haider, Shamim A Qazi.
Malaria in neonates.
Pak Paed J Jan ;19(2):81-2.

Hareem Fatima, 21 days old female baby admitted with complaints of irritability for 3 days, poor feeding for 2 days and fever for one day. The fever was high grade and remittent. There was no breathing difficulty or convulsions. Her mother had two episodes of fever just before pregnancy which were clinically diagnosed by her physician as malaria. She was given antimalarial after which she become asymptomatic. At 28 weeks of gestation she again developed remittent fever of moderate intensity which settled on its own in one week. She only took antipyretics during this episode. Birth history was normal and the baby weighed 2.6 kg at birth. On admission baby was lethargic, pale and mildly dehydrated. Temperature 100.4F, heart rate 136/min and respiratory rate 44/min. Her head circumference of 36 cm, length of 56 em and weight of 3.1 kg were normal for her age. There was no clinical jaundice or cyanosis but anterior fontanelle was full and neonatal reflexes weak. Her liver was 2cms and spleen was 1.5cm paplable. The slide for malarial parasite was negative on first blood picture examination. A clinical diagnosis of neonatal septicemia was made and baby was started on Inj. ceftriaxone and ampicillin in appropriate doses. Despite the antibiotics the fever did not settle even after 48 hours. Her blood picture was repeated on the fourth day and MP slide showed heavy infestation of trophozoite and shizont stage of plasmodium vivax. She was given amodiaquine for three days and her fever settled with improvement of her symptoms.

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