Malaria congénita: A propósito de un caso / Congenital malaria: Case report

La malaria congénita es una patología relativamente rara en el contexto de las patologías neonatales. El presente caso se trata de un recién nacido masculino de 24 días de vida con malaria congénita por Plasmodium vivax y falciparum cuyo diagnóstico se observó a través del estudio de la gota gruesa. El recién nacido es procedente de una zona poco endémica, pero la madre viajó por compromiso laborales en varias ocasiones a una zona endémica en el Estado Bolívar. La madre presentó malaria gestacional a partir del I trimestre de gestación con tratamiento irregular. Las manifestaciones clínicas del recién nacido fueron fiebre de 40°c y el tratamiento antimalárico fue con Artesunate 60 mg con adecuada respuesta clínica, confirmada mediante la negativización de la gota gruesa al finalizar el tratamiento. Es importante considerar el diagnóstico diferencial con el de sepsis neonatal sobre todo en pacientes procedentes de zonas de riesgo y endémicas. La malaria congénita es real y por lo tanto se recomienda que los recién nacidos de madres con malaria deben ser examinados inmediatamente.

Congenital malaria is a relatively rare disease in the context of neonatal pathologies. We present a case of a 24 day old newborn male with congenital malaria by Plasmodium vivax and falciparum whose diagnosis was performed through the study of thick film. The newborn comes from a non- endemic area were as the mother because of worktravelled to an endemic area of our country in Bolivar state. The mother had a maternal history of seasonal malaria during the I trimester of gestation with irregular treatment. The clinical manifestation of the newborn was fever 40 °c and the antimalarial treatment was performed with Artesunate at 60 mg with adequate clinical response, confirmed by the thick film negativization at the end of the treatment. It is important to consider the differential diagnosis with neonatal sepsis especially in patients from endemic areas and risk. Congenital malaria is real and therefore it is recommended that newborns of mothers with malaria should be examined immediately.

Use of buffy coat thick films in detecting malaria parasites in patients with negative conventional thick films

Objective: To determine the frequency of malaria parasite detection from the buffy coat blood ilms by using capillary tube in falciparum malaria patients with negative conventional thick ilms. Methods: Thirty six uncomplicated falciparum malaria patients confirmed by conventional thick and thin films were included in the study. The patients were treated with artemisinin combination therapy at Hospital for Tropical Diseases, Bangkok, Thailand for 28 day. Fingerpricks for conventional blood films were conducted every 6 hours until negative parasitemia, then daily fingerpricks for parasite checks were conducted until the patients were discharged from hospital. Blood samples were also concurrently collected in 3 heparinized capillary tubes at the same time of fingerpricks for conventional blood films when the prior parasitemia was negative on thin films and parasitemia was lower than 50 parasites/200 white blood cells by thick film. The first negative conventional thick films were compared with buffy coat thick films for parasite identification.Results:Out of 36 patients with thick films showing negative for asexual forms of parasites, buffy coat films could detect remaining 10 patients (27.8%) with asexual forms of Plasmodium falciparum. Conclusions: The study shows that buffy coat thick films are useful and can detect malarial parasites in 27.8% of patients whose conventional thick films show negative parasitemia.