Abstract Ref Number = APCP953
CONGENITAL MALARIA DUE TO PLASMODIUM VIVAX A CASE REPORT
Anggia Rarasati Wardhana,Sukartini S,Loly Rotua D Siagian,Lily Pertiwi Kalalo
IDAI PDS PATKLIN
Background : Congenital malaria is an infectious disease caused by the malaria parasite that is transmitted from mother to child through placenta during pregnancy or at delivery. In areas where malaria is endemic, infants aged <3 months appear to be relatively protected from symptomatic and severe Plasmodium falciparum malaria, but less is known about the effect of Plasmodium vivax infection in this age group. Diagnosis of congenital malaria is difficult because of the similarity in clinical presentation with other infections.
Case Presentation Summary : A 24-days old boy, hospitalized with repeated fever, intermittent, vomiting, and diarrhea with decreased appetite. Physical exams revealed pale conjunctiva, jaundice sclera and body, hepatosplenomegaly with dilatation of veins in the surface of abdomen. Mother had had suffered from malaria at the 7 months of pregnancy and hospitalized. Parents were living in Papua for 2 years. Laboratory findings showed hemoglobin 7 g/dL, leukocytes 17.320/ml, MCV 90,4 fl, MCH 28,8 pg, MCHC 31,8 g/dl, thrombocytes 49.000/ml, erythrocytes 2,42x10^6ml, RDW-SD 56,4 fl, RDW-CV 17,5%, SGOT 108 U/L, SGPT 72 U/L, bilirubin total 13,5 mg/dl, bilirubin direct 10,0 mg/dl, bilirubin indirect 3,5 mg/dl, alkali phosphatase 373 U/L, gamma GT 158 U/L. Parasite Count was 4070/µl. Peripheral blood smear showed gametocytes of Plasmodium vivax stadium trophozoite, his mother’s peripheral smear for malaria was positive. The patient was treated with chloroquin in doses of 10 mg/kgBW and followed by 5 mg/kgBW, but had no response, then replaced with DHP for three days. After 19 days hospitalized, clinical symptoms were improved and repeated of peripheral smear was negative.
Learning Points/Discussion : In infants from mothers with any history of malaria fever at antenatal period, malaria should be suspected in any neonate with fever and anemia with hepatosplenomegaly. Early diagnosis and treatment could effectively prevent infant mortality
Keywords: Congenital malaria Plasmodium vivax chloroquin DHP