Ibhanesebhor S E, Okolo A A
Department of Child Health, University of Benin Teaching Hospital, Nigeria.
Ann Trop Paediatr. 1992;12(3):297-302. doi: 10.1080/02724936.1992.11747588.
In a study of neonatal malaria at the University of Benin Teaching Hospital, we documented the features of six neonates in an effort to highlight that the manifestations of malaria in the newborn cannot be readily distinguished from those of neonatal sepsis. Maternal peripartum fever, an important identifiable risk factor for neonatal sepsis, also featured prominently in the mothers of these babies. These mothers ingested pyrimethamine weekly in the course of their pregnancy. All six neonates were critically ill. Their cultures of blood, CSF and urine for bacterial pathogens yielded no growth and they were unresponsive to conventional antibiotics. The diagnosis of malaria should be considered, in spite of regular maternal ingestion of antimalarial prophylaxis with pyrimethamine, in critically ill neonates in malarious areas. All six neonates responded satisfactorily to oral doses of chloroquine. We therefore suggest that a blood film for malaria parasites be included in screening for neonatal sepsis as part of the initial work-up.
在贝宁大学教学医院进行的一项新生儿疟疾研究中，我们记录了6名新生儿的特征，以强调新生儿疟疾的表现不易与新生儿败血症的表现区分开来。产妇围产期发热是新生儿败血症的一个重要可识别风险因素，在这些婴儿的母亲中也很突出。这些母亲在孕期每周服用乙胺嘧啶。所有6名新生儿病情都很危急。他们的血液、脑脊液和尿液进行细菌病原体培养均无生长，且对常规抗生素无反应。尽管母亲定期服用乙胺嘧啶进行疟疾预防，但在疟疾流行地区的危重新生儿中，仍应考虑疟疾的诊断。所有6名新生儿口服氯喹后反应良好。因此，我们建议作为初步检查的一部分，在新生儿败血症筛查中增加疟原虫血涂片检查。
