Bilateral Cervical Lymphadenopathy Atypical Presentation of Malaria-A Rare Case Report

Malaria, the most common parasitic disease of humans, remains a major health and economic burden in most tropical countries. An 18-year-old male from rural north eastern India presented with four days fever with chill. The patient was conscious, oriented but confused. Physical examination revealed bilateral multiple, discrete cervical lymphadenitis without organomegaly or sternal tenderness. Blood parameters were normal except transient thrombocytopenia. Blood smear and antigen were positive for both Plasmodium vivax and falciparum with negative viral markers. Fine Needle Aspiration Cytology (FNAC) of cervical lymph nodes showed non-specific reactive lymphadenitis which subsided with antimalarial treatment. Lymphadenitis is an extremely rare presentation in malaria and is considered as an important negative finding. We reported this case to highlight that such unusual manifestations may present in malaria in endemic areas which may baffle the clinicians.