Hafsatu A., 2

Child excessively cries especially when she is hungry, likes playing with her toys and interact with her siblings. She was well until 2 days before the presentation when she started having fever, diarrhea, refusal to feed, and inability to sit or stand. Fever is said to be high-grade, intermittent, and not relieved by ingestion of paracetamol. The diarrhea is said to be watery, non-mucoid, and non-bloody about 5 episodes a day. No history of vomiting, however, there is a history of marked abdominal distension. Pt is said to be not sleeping under a mosquito net. No history of convulsion or loss of consciousness. On examination: Acutely ill-looking, irritable, lethargic, Febrile (39.2 degrees centigrade), mildly pale, acyanosed, anicteric, dehydrated. ABD: Flat, MWR, soft, non-tender, liver and spleen not palpably enlarged, kidneys are not ballotable. A diagnosis of severe malaria with prostration to r/o electrolyte derangement.

Hafsatu was admitted in our facility where she was managed as a case of severe malaria presenting as convulsions. She received her full dosages of IV antimalarials and other supportive medications. She responded well to the management instituted as evidenced by resolving of her presenting symptoms. She was later placed on oral medications to complete her treatment before when was later discharged home. Parents were very grateful to helpster for coming to her aid.

The patient needs admission, and the following investigations are essential: Malaria parasite (MP), FBC, EUCr, and Random blood glucose. IV antimalarial, fluid and electrolyte replacement are needed. If the patient is left untreated, he is at risk of vital organ damage.