Case Report
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World J Clin Infect Dis. May 25, 2014; 4(2): 5-8
Published online May 25, 2014. doi: 10.5495/wjcid.v4.i2.5
Unsuspected imported malaria in a case of sudden infant death
Teresa Pusiol, Anna Maria Lavezzi, Ferdinando Radice, Graziella Alfonsi, Luigi Matturri
Teresa Pusiol, Institute of Anatomic Pathology, Rovereto Hospital, Rovereto (Trento) 38068, Italy
Anna Maria Lavezzi, Ferdinando Radice, Graziella Alfonsi, Luigi Matturri, Department of Biomedical, Surgical and Dental Sciences, “Lino Rossi” Research Center, University of Milan, Milan 20122, Italy
Author contributions: Pusiol T, Lavezzi AM, Radice F, Alfonsi G and Matturri L contributed to this work.
Correspondence to: Teresa Pusiol, MD, Institute of Anatomic Pathology, Rovereto Hospital, Piazzale S.Maria 6, Rovereto (Trento) 38060, Italy. teresa.pusiol@apss.tn.it
Telephone: +39-04-64403505 Fax: +39-04-64403029
Received: April 8, 2014
Revised: April 23, 2014
Accepted: May 20, 2014
Published online: May 25, 2014
Abstract

Here we describe the case of a 4-mo-old female who died suddenly without any apparent cause that was initially mistaken as a case of sudden infant death syndrome. Histologic observation of brain sections revealed blue-black bodies in erythrocytes of the blood vessels, suggestive of specific stages of the hematic schizogonic cycle. Further examinations revealed hemozoin and hemosiderin deposits in the parenchyma of all organs, leading to the diagnosis of malaria by Plasmodium falciparum (P. falciparum). The death occurred in Italy, the native country of the infant, two weeks after a Christmas holiday spent in Pakistan, the parents’ birthplace, which has a high malarial endemicity. As this case demonstrates, the diagnosis of malaria should always be considered as a differential diagnosis in subjects, including infants, that die unexpectedly after returning from P. falciparum endemic areas.

Keywords: Parasitemia, Plasmodium falciparum, Protozoa, Sudden infant death, Unsuspected imported malaria

Core tip: This report describes the case of a 4-mo-old baby whose sudden death was initially attributed to sudden infant death syndrome. Histologic examination of organ specimens unexpectedly revealed blue-black bodies in erythrocytes, suggestive of specific stages of the hematic schizogonic cycle, and hemozoin and hemosiderin deposits in the parenchyma of all organs. These observations led to the diagnosis of death from malaria by Plasmodium falciparum. In support of this diagnosis, the baby had recently returned from a stay in Pakistan, a region with high malarial endemicity.