Imported pediatric malaria presenting to an urban pediatric emergency department: a case series.

Abstract:

OBJECTIVE:The objective of this study was to identify common presenting signs, symptoms, and laboratory findings of imported pediatric malaria presenting to a US pediatric emergency department (ED). METHODS:This is a retrospective chart review of all patients presenting to an urban pediatric ED between July 1, 2004, and July 1, 2011, who were assigned an ED or inpatient discharge diagnosis of "malaria" and had a confirmed blood smear demonstrating plasmodium species. RESULTS:There were 21 patients included in this study (median age, 12 years; range, 19 months to 22 years). A total of 15 (71%) were infected with Plasmodium falciparum subtype of malaria. Patients presented to the ED between 1 day and 2 years after return from a malaria-endemic area. All 21 patients (100%) reported a history of fever, but only 9 (43%) had a fever documented in the ED. Of the patients, 14 (66%) complained of headache, 13 (62%) complained of anorexia, 11 (52%) complained of chills, and 10 (48%) complained of abdominal pain. The most common sign was tachycardia, present in 18 patients (86%). Consistent with other studies, thrombocytopenia was the most frequently observed laboratory abnormality, present in 16 patients (76%). CONCLUSIONS:The presenting signs and symptoms of imported pediatric malaria are nonspecific and inconsistently present, underscoring the importance of maintaining a high index of suspicion for this diagnosis in any patient returning from a malaria-endemic region.

journal_name

Pediatr Emerg Care

journal_title

Pediatric emergency care

authors

Schwartz KR,Vinci R

doi

10.1097/PEC.0b013e318276c88c

subject

Has Abstract

pub_date

2012-12-01 00:00:00

pages

1385-8

issue

12

eissn

0749-5161

issn

1535-1815

pii

00006565-201212000-00027

journal_volume

28

pub_type

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