Affiliations: Department of Pediatrics, University of Padua,
Italy | Clinical Microbiology and Virology, Padua University
Hospital, Padua, Italy | Department of Oncology and Surgical Sciences, AIDS
Reference Center, University of Padua, Italy | Trento Santa Chiara Hospital, Trento, Italy
Note: [] Correspondence: Dr. Martina Penazzato, Department of Pediatrics,
University of Padua, via Giustiniani 3, 35128 Padua, Italy. Tel.: +39 49
8213585; Fax: +39 49 8753865; E-mail: [email protected]
Abstract: We report a case of congenital Plasmodium ovale malaria in an
infant born to an human immunodeficiency virus ositive Nigerian woman living in
Italy throughout pregnancy. In the fifth week of life, while on prophylactic
treatment with zidovudine (ZDV), 2 mg/kg/day, the baby developed marked anemia
(Hemoglobin: 6.2 g/dL) without any other symptoms. Although ZDV was immediately
stopped, the anemia worsened during a second determination (Hemoglobin:
5.4 g/dL), five days later when the mother could be contacted. Blood smear
showed the presence of P. ovale, also confirmed by real-time polymerase
chain reaction amplification and sequencing. The baby was hemotransfused and
successfully treated with oral quinine sulphate (20 mg/kg/day) for five days
and repeated blood smear became negative for malaria. Polymerase chain reaction
and viral culture for human immunodeficiency virus at 4 months of age were
negative. This report suggests that symptomatic congenital malaria may be
present even in European countries and should be considered in the differential
diagnosis of anemia in infants, born to human immunodeficiency virus positive
immigrant mothers, receiving ZDV prophylaxis.