Plasmodium vivax congenital malaria in a newborn of a Zairian immigrant

We report a case of congenital malaria in a newborn whose mother is a native of Zaire now living in Italy. The baby developed remittent fever in the 3rd week of life with anaemia and hepatosplenomegaly. Malaria parasites found in blood smears and erroneously diagnosed initially as Plasmodium falciparum were subsequently recognized as Plasmodium vivax. On the basis of the first diagnosis, treatment with quinine chlorhydrate was successfully undertaken without significant side-effects. P. vivax parasites were also recovered a posteriori in blood smears of the mother who was febrile during the week of her delivery. This report suggests that symptomatic congenital malaria may be more common than is generally thought and should be suspected in non-malarious countries in febrile newborns born to mothers who have travelled in or immigrated from malaria-endemic areas.