Congenital malaria with chloroquine resistance

Summary

A preterm infant with possible congenital clinical malaria is described. The infant developed persistent pyrexia, hyperbilirubinaemia, anaemia, increasing gastric residuals and hepatosplenomegaly from the 7th day of life. Thick and thin smears of the infant's blood were heavily loaded with various asexual stages of Plasmodium falciparum. The parasite exhibited R1 resistance. There was no satisfactory response to chloroquine, but response to intravenous quinine therapy was achieved on day 15. The initial 6-month follow-up period was uneventful. The mother had apparently had chloroquine-resistant malaria which responded to sulfadoxine-pyrimethamine (Fansidar).