Unusual presentations of malaria in children: an experience from a tertiary care centre in north east India.

Objective. To identify cases of malaria with unusual presentations. Methods. The medical record of all the cases of malaria admitted to PICU and pediatric general ward from Oct 2006 to Sep 2009, were reviewed and cases with unusual presentations were identified. The study design was retrospective descriptive study. Results. Sixteen (10%) out of 162 malaria cases had unusual presentations - three had hemiplegia, two each with viral hepatitis-like presentation, acute abdomen, gastrointestinal bleed, generalized edema and hyperglycemia and one each with ptosis, severe headache and subacute intestinal obstruction-like presentation. Eleven cases had mixed parasitemia and two each with P. vivax and P. falciparum. One case was diagnosed on clinical grounds. Conclusions. Malaria is a common disease, but both typical and atypical presentations deserve attention for early diagnosis and management.