Plasmodium vivax presenting as acute glomerulonephritis in a 3-year-old child

Although acute glomerulonephritis is a rare complication of Plasmodium falciparum malaria, it has not been reported in connection with Plasmodium vivax. We report a case of complicated P. vivax malaria presenting as acute glomerulonephritis. A three-year-old boy presented with high grade fever, a seven-day history of the progressive swelling of his body and a one-day history of vomiting. An examination revealed hypertension (>95th percentile), pallor and hepatosplenomegaly. Investigations showed a platelet count 80,000/mm(3) with haematuria [20-30 red blood cells/high power field with more than 80% dysmorphic red blood cells]. A peripheral smear showed the presence of trophozoites of P. vivax. The patient was diagnosed as having P. vivax causing acute glomerulonephritis and was treated successfully with antimalarials and enalapril. With the changing epidemiological pattern of malaria, especially in endemic areas, unusual complications such as acute glomerulonephritis may sometimes present in cases of P. vivax malaria.