Background Malaria during first few months of life may be due to transplacental transfer of parasitized maternal erythrocytes. Although IgG and IgM antimalarial antibodies can be detected in maternal blood, only IgG antibodies are present in the infant's blood. These antibodies can delay and modify the onset of clinical manifestations. Case Presentation An infant is described who presented with irritability and feeding problems. Clinical examination and investigations revealed that the infant was afebrile, had jaundice, hepatosplenomegaly and haemolytic anaemia. Peripheral smear demonstrated Plasmodium vivax. While the mother had significant levels of immunoglobulin G (IgG), the infant was found negative for IgG and had low immunoglobulin M (IgM) levels. The mother had a history of febrile illness during pregnancy and her peripheral smear was also positive for P. vivax. Both were successfully treated with chloroquine in the dose of 25 mg/kg/day over three days. Conclusion The case emphasizes the importance of considering the diagnosis of malaria even in infants in low transmission area, who may not present with typical symptoms of malaria, such as fever, but have other clinical manifestations like jaundice and haemolytic anaemia.
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机译：背景生命最初几个月中的疟疾可能是由于寄生了的母体红细胞经胎盘转移所致。尽管可以在母体血液中检测到IgG和IgM抗疟抗体，但婴儿血液中仅存在IgG抗体。这些抗体可以延迟和改变临床表现的发作。病例介绍描述了一个婴儿出现烦躁和喂养问题。临床检查和调查显示，该婴儿无发热，黄疸，肝脾肿大和溶血性贫血。外周涂片显示间日疟原虫。母亲的免疫球蛋白G（IgG）水平较高，而婴儿的IgG阴性，免疫球蛋白M（IgM）水平较低。母亲有怀孕期间的高热病史，她的外周涂片也对间日疟原虫呈阳性。两者均在三天内成功用25 mg / kg / day的氯喹剂量治疗。结论该病例强调了即使在低传播地区的婴儿中也要考虑诊断疟疾的重要性，这些婴儿可能没有典型的疟疾症状，例如发烧，但具有黄疸和溶血性贫血等其他临床表现。
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