Congenital malaria due to Plasmodium vivax infection in a neonate

Introduction: Congenital malaria occurs through vertical transmission of parasites from mother during pregnancy/perinatally during labour. Presence of maternal antibody may delay symptoms upto 3-6 weeks after birth. Case Representation: A 21days neonate presented with not accepting feed, excessive crying, fever since 2days. On examination baby was pale, lethargic, febrile, hepatosplenomegaly+. Peripheral smear-rings & trophozoits of P. vivax , diagnosed as congenital malaria with neonatal sepsis. IV. Ceftriaxone, IV. Amikacin started. Chloroquine was given. Discussion: This case shows importance of considering congenital malaria as differential diagnosis of neonatal sepsis in neonates with history of malaria during pregnancy. Mechanisms for congenital transmission of malaria include maternal transfusion into fetal circulation at delivery/during pregnancy. Sometimes mother might had mild episode malarial during the 9 th month of pregnancy, resolved spontaneously, and remained undiagnosed. The time of onset of symptoms in congenital malaria can vary from immediately after birth to few weeks. The drug of choice for congenital malaria remains chloroquine.