Patient selection: neonate with congenital malaria
Reasons for missing the diagnosis of congenital malaria:
(1) maternal exposure to malaria unknown
(2) placenta not examined
(3) neither cord nor peripheral blood examined microscopically
(4) small number of parasites in the blood
(5) misdiagnosis as neonatal sepsis
(6) mixed infection, with malaria and another pathogen
(7) death of the neonate prior to evaluation
Steps to consider in order to make a diagnosis of congenital malaria:
(1) to examine the peripheral blood smear of the neonate carefully
(2) to suspect congenital malaria if the mother has had any exposure to malaria, especially if there is documented infection in the late third trimester
(3) to perform PCR on the blood
Differential diagnosis:
(1) neonatal malaria (transmission to the neonate by a mosquito or blood transfusion, usually in an endemic region)
