Skip to main content

Advertisement

SpringerLink
Log in

Unusual presentations of malaria in children: An experience from a tertiary care centre in North East India

  • Original Article
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

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.

Conclusion

Malaria is a common disease, but both typical and atypical presentations deserve attention for early diagnosis and management.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Barnett ED. Malaria. In Feigin Cherry, Demmer and Kaplan eds. Textbook of Pediatric Infections Diseases, 5th ed. Elsevier; Saunders; 2714–2720.

  2. World Health Organization: Management of severe malaria: A practical handbook, 2nd ed. 2000.

  3. White NJ. Malaria. In Gordon Cook, Alimuddin Zumla, eds. Manson’s TB of Tropical Medicine, 21st ed. Saunders, 2003; 1205–1295.

  4. Taksande A, Vilhekar K, Jain M, Atkari S. Clinicohaematological profile of cerebral malaria in a rural hospital. JIACM 2006; 7: 308–312.

    Google Scholar 

  5. Gordon S, Brennessel DJ, Goldstein JA, Rosner F. Malaria: A city hospital experience. Arch Intern Med 1998; 148: 1569–1571.

    Article  Google Scholar 

  6. Ramana Murty CHV, Prabhakar YVS, Rao VBB, Jonnalangadda SS. Drug resistant falciparum malaria with bowel symptoms. Am J Gastroenetrol 2000; 95: 1101.

    Article  Google Scholar 

  7. Gopisetty S, Sarveswaran J, Achuthan R, Davies J, Ausobsky JR. Acute surgical abdomen—an atypical presentation of Plasmodium vivax malaria. Gut 2007; 56: 447–448.

    Article  PubMed  Google Scholar 

  8. Seydel KB, Milner DA, Kamiza SB, Molyneux ME, Taylor TE. The distribution and intensity of parasite sequestration in comatose Malawian children. J Infect Dis 2006; 194:208–215.

    Article  PubMed  Google Scholar 

  9. Clark IA, Budd AC, Alleva LM, Cowden WB. Human malarial disease: a consequence of inflammatory cytokine release. Malaria J 2006; 5: 85.

    Article  Google Scholar 

  10. Kochar DK, Agarwal P, Kochar SK et al. Hepatocyte dysfunction and hepatic encephalopathy in plasmodium falciparm malaria. Q J Med 2003; 96: 505–512.

    CAS  Google Scholar 

  11. Mahmood K, Jairamani KL, Abbasi B et al. Falciparum malaria: various presentations. Pak J Med Sci 2006; 22: 234–237.

    Google Scholar 

  12. Chawla LS, Sidhu G, Sabharwal BD, Bhatia KL, Sood A. Jaundice in Plasmodium falciparum malaria. J Asso Phys India 1989; 37: 390–392.

    CAS  Google Scholar 

  13. Anand AC, Ranji C, Narula AS, Singh W. Histopathological changes of liver in malaria: a heterogenous syndrome? Natl Med J India 1992; 5: 59–62.

    CAS  PubMed  Google Scholar 

  14. Murthy GL, Sahay RK, Sreenivas DV, Sundaram C, Shantaram V. Hepatitis in falciparum malaria. Trop Gastroenterol 1998; 19: 152–154.

    CAS  PubMed  Google Scholar 

  15. Brewster DR, Kwiatkowski D, White NJ. Neurological sequelae of cerebral malaria in children. Lancet 1990; 336: 1039–1043.

    Article  CAS  PubMed  Google Scholar 

  16. Molyneux ME, Taylor TE, Wirima JJ, Borgstein A. Clinical features and prognostic indicators in paediatric cerebral malaria: a study of 131 comatose Malawian children. Q J Med 1989; 71: 441–459.

    CAS  PubMed  Google Scholar 

  17. Schmutzhard E, Gerstenbrand F. Cerebral malaria in Tanzania. Its epidemiology, clinical symptoms and neurological long term sequelae in the light of 66 cases. Trans R Soc Trop Med Hyg 1984; 78: 351–353.

    Article  CAS  PubMed  Google Scholar 

  18. Kochar DK, Shubhakaran, Kumawat BL et al. Cerebral malaria in Indian adults: A prospective study of 441 patients from Bikaner, North West India. J Asso Phys of India 2002; 50: 234–241.

    CAS  Google Scholar 

  19. G Bedu-Addo. Bilateral ptosis induced by chloroquine. Trans R Soc Trop Med Hyg 2006; 100: 696–697.

    Article  CAS  PubMed  Google Scholar 

  20. Beare NA, Riva CE, Taylor TE et al. Changes in optic nerve blood flow in children with cerebral malaria and acute papilloedema. J Neurol Neurosurg Psychiatry 2006; 77: 1288–1290.

    Article  CAS  PubMed  Google Scholar 

  21. Tombe M, Bhatt KM, Obel AO. Clinical surprises and challenges of severe malaria at Kenyatta National Hospital, Kenya. East Afr Med J 1993; 70: 117–119.

    CAS  PubMed  Google Scholar 

  22. Rajapurkar MM. Renal involvement in malaria. J Postgrad Med 1994; 40: 132.

    CAS  PubMed  Google Scholar 

  23. Areekul S, Kasemsuth R, Kanakakorn K. Studies on the transcapillary escape rate of fibrinogen and capillary permeability in patients with Plasmodium falciparum malaria. Trop Geogr Med 1984; 36: 151–157.

    CAS  PubMed  Google Scholar 

  24. Areekul S. Transcapillary escape rate and capillary permeability to albumin in patients with Plasmodium falciparum. Ann Trop Med Parasitol 1988; 82: 135–140.

    CAS  PubMed  Google Scholar 

  25. Sowunmi A. Renal function in acute falciparum malaria. Archives of Disease in Childhood 1996; 74: 293–298.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Disciplines, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, Meghalaya, India

    Rashna Dass, Himesh Barman, Saurabh Gohain Duwarah, Nayan Mani Deka, Pankaj Jain & Vivek Choudhury

  2. Department of Pediatric Disciplines, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Room no. 218, PO: Mawdiangdiang, Shillong, 793018, India

    Rashna Dass

Authors
  1. Rashna Dass
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Himesh Barman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Saurabh Gohain Duwarah
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nayan Mani Deka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pankaj Jain
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Vivek Choudhury
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rashna Dass.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dass, R., Barman, H., Duwarah, S.G. et al. Unusual presentations of malaria in children: An experience from a tertiary care centre in North East India. Indian J Pediatr 77, 655–660 (2010). https://doi.org/10.1007/s12098-010-0055-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-010-0055-8

Key words

Search

Navigation