Infectious and Tropical Disease Division, Faculty of Medicine, Department of Pediatrics, Sam Ratulangi University, Manado, Indonesia.
Pediatric Infectious and Tropical Disease Division, Department of Pediatrics, Faculty of Medicine, Prof. Dr. R. D. Kandou General Hospital, Manado, Indonesia.
Am J Trop Med Hyg. 2018 Mar;98(3):656-659. doi: 10.4269/ajtmh.17-0739. Epub 2018 Jan 4.
Severe congenital malaria associated with is uncommon. In Indonesia, most congenital malaria cases are due to infections. Most cases of congenital or neonatal malaria in endemic areas are diagnosed from peripheral smear as part of routine sepsis workup. Differentiating congenital and acquired neonatal malaria is very difficult. The case presented in this study describes severe malaria with cholestatic jaundice and sepsis-like signs and symptoms in neonates. The mother was asymptomatic and the neonate was successfully treated with intravenous artesunate. Severe malaria with cholestatic jaundice in neonates is an uncommon condition that should be included in the differential diagnosis of infants displaying hemolytic anemia, thrombocytopenia, cholestatic jaundice, and hepatosplenomegaly in malaria-endemic zones. Early diagnosis can prevent the use of unnecessary antibiotics and mortality of neonates.
严重先天性疟疾伴 感染并不常见。在印度尼西亚，大多数先天性疟疾是由 感染引起的。在流行地区，大多数先天性或新生儿疟疾病例是通过外周血涂片作为常规败血症检查的一部分来诊断的。区分先天性和获得性新生儿疟疾非常困难。本研究中提出的病例描述了严重的疟疾，伴有胆汁淤积性黄疸和类似败血症的症状和体征。母亲无症状，新生儿成功接受了静脉注射青蒿琥酯治疗。新生儿伴有胆汁淤积性黄疸的严重疟疾并不常见，在疟疾流行地区，出现溶血性贫血、血小板减少、胆汁淤积性黄疸和肝脾肿大的婴儿应将其纳入鉴别诊断。早期诊断可以防止不必要的抗生素使用和新生儿死亡。
