Congenital Malaria in a Neonate: A Case Report from a Tertiary Hospital in South-South Nigeria
Ikechukwu Francis Agwu *
Department of Medical Microbiology and Parasitology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom, Nigeria.
Samuel Ibok
Department of Medical Microbiology and Parasitology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom, Nigeria.
Ekemini Udo
Department of Pediatrics, University of Uyo Teaching Hospital, Uyo, Akwa Ibom, Nigeria.
Idakari Nweke
Department of Medical Microbiology and Parasitology, Alex Ekwueme Federal, University Teaching Hospital, Abakiliki, Ebonyi, Nigeria.
Chinedum Amagwu
Department of Medical Microbiology and Parasitology, Enugu State University Teaching Hospital, Enugu, Nigeria.
Augusta Mgbedimma
Department of Medical Microbiology and Parasitology, Veritas University Abuja, Gaba, Nigeria.
Anozie Chikezie Enyinnaya
Department of Medical Microbiology, College of Medicine and Health Sciences, Gregory University Uturu, Abia, Nigeria.
Okafor Johnbosco Chidozi
Department of Chemical Pathology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom, Nigeria.
Anietie Arthur Etuk
Department of Chemical Pathology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom, Nigeria.
Ekanem Emmanuel
Department of Haematology and Blood Transfusion, University of Uyo Teaching Hospital, Uyo, Akwa Ibom, Nigeria.
Chisom Ntomchukwu
Department of Haematology and Blood Transfusion, University of Uyo Teaching Hospital, Uyo, Akwa Ibom, Nigeria.
Christian Junior Ide
Department of Medical Microbiology and Parasitology, University of Calabar Teaching Hospital, Cross River State, Nigeria.
Essien Udobong McEinsten
Department of Morbid Anatomy, University Teaching Hospital, Akwa Ibom, Nigeria.
Loretta Odigie
Department of Medical Microbiology and Parasitology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Congenital malaria may occur when malaria parasites are transmitted from mother to infant during pregnancy or delivery. Its clinical presentation can overlap with other causes of neonatal illness, creating diagnostic difficulty.
Case Presentation: This report describes a 9-day-old female neonate admitted to the University of Uyo Teaching Hospital, Akwa Ibom State, Nigeria, with respiratory distress and persistent fever. She was born to a 25-year-old primigravida who had received antenatal care and was treated for Plasmodium falciparum malaria nine days before delivery. On examination, the neonate weighed 3,300 g, had a temperature of 38 °C and a respiratory rate of 70 breaths/min, and had an oxygen saturation of 90% on room air. A provisional diagnosis of neonatal sepsis prompted treatment with intravenous ceftriaxone, but the fever persisted. Blood film microscopy subsequently identified Plasmodium falciparum parasitaemia. Bacterial cultures were negative, and the chest radiograph was reported as normal. At the time of the neonate's diagnosis, the mother was asymptomatic and had negative malaria rapid diagnostic and microscopy results. Treatment with intravenous artesunate followed by oral artemisinin–lumefantrine was associated with clinical recovery.
Conclusion: This case illustrates the importance of including malaria in the differential diagnosis of a febrile neonate when maternal malaria has been documented during pregnancy. Careful maternal history-taking and prompt parasitological investigation may support appropriate management.
Keywords: Congenital malaria, Neonate, Plasmodium falciparum, Nigeria