Tariq Mahmood, Sajid Maqbool, Rashid Mahmood.
Malaria as a cause of acute fever without localizing signs (AFWLS) in children.
Pak Paed J Jan ;23(1):9-11.

Fever is a common presenting complaint in children and often presents without any localizing signs especially in infants. Recognizing this, a separate entity "Acute fever without localizing signs of infection" (AFWLS) has been accepted and is defined as fever of relatively sudden onset with no abnormal finding on physical examination suggesting the diagnosis of specific disease. In our part of the world malaria is often considered a common cause of AFWLS and is empirically treated. In order to determine the incidence of malaria as a cause of AFWLS, children aged 2 months to 13 years with AFWLS were subjected to detailed history, physical examination and routine tests, which included CBC, Hb, Platelets , RBC indices, urine R/E, C/S and other tests (LFT, blood US, etc.) as indicated. Thick and thin blood smears for malarial parasite detection were made in children. Of the 285 cases, 165 (58%) were male and the mean age was 5 years. A total of 38 cases (13.3%) were positive for malaria. Beside fever (100%) other significant findings were rigors (87.4%) headache (57%) and abdominal pain (2G%). Malaria should therefore be actively considered as a cause of AFWLS in children in our part of the world.

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