Congenital Plasmodium vivax in a 3-day-old neonate: a case report.

Background: Congenital malaria is an uncommon clinical infectious disease caused by vertical transmission of parasites from mother to child during pregnancy or delivery and a positive blood smear of malaria in newborns from 24 hours to 7 days of life, associated with a high mortality rate if it is not diagnosed and treated early. We present an unusual case of a 4-day-old boy with Plasmodium vivax malaria from Gondar, Ethiopia, suspected mainly based on a positive maternal history of malaria attacks in the seventh month of gestation and cured with artemether-lumefantrine therapy. The newborn presented with a lack of sucking and a high-grade fever. The blood film of the baby showed a trophozoite stage of Plasmodium vivax with a parasite density of +2. The neonate had severe thrombocytopenia (76,000/μL) and splenomegaly (the spleen was palpable 2 cm along the growth line). The patient was admitted to the hospital and was treated with artesunate and artemether-lumefantrine.

Conclusion: Most of the Amhara zones are endemic for malaria, and newborns born to mothers in malaria areas or those with a history of malaria attacks in the index pregnancy should be investigated early for malaria rather than treated with sepsis or meningitis. It is wise to consider congenital malaria as part of neonatal sepsis-like presentations, especially if there is a maternal history of malaria attack during pregnancy and if the neonates fully recover.