Congenital malaria: Is it really rare? A case report

A 7-day-old term male infant weighing 2.4 kg was admitted with fever, pallor, icterus, and splenomegaly for 3 days. The primi mother was treated for pyrexia in the last trimester. Investigation revealed anemia, hyperbilirubinemia, and thrombocytopenia and demonstrated Plasmodium vivax in peripheral blood smear and card test. C-reactive protein was raised and blood culture was sterile. The baby was responded well to intravenous (IV) artesunate. Recent studies suggest that congenital malaria (CM) is not as rare as previously thought. Cord blood shows greater parasitemia as compared to neonatal blood. Besides light microscopy, plasmodium antigen detection and polymerase chain reaction of blood may help in diagnosis. CM can be confused with toxoplasmosis, rubella, cytomegalovirus, herpes simplex syndrome, and neonatal sepsis.