Khadijah N., 10

Khadijah is 10 years old, she is the second child among 4 children, she stays with her parents. Currently, Khadijah does not go to school because the parents cannot afford to pay for her school fees. The father does not have a job to the moment, they're struggling to feed, the mother is a house wife. Khadijah presented with the complaint of headache, abdominal pain, severe fever, catarrh, vomiting everything, bitter taste and watery stool. Parents noted progressive lethargy and reduced oral intake. No prior treatment except antipyretics. The child appeared acutely ill, febrile, dehydrated, and pale. Vital signs: high fever, tachycardia, and mild tachypnea. Abdominal exam showed right upper quadrant tenderness and mild hepatosplenomegaly. Neurological exam normal with no convulsions. She was brought to our facility for further evaluation. Upon presentation at our hospital and after further evaluation he was diagnosed with Malaria + Enteric fever.

Khadijah a 10year old presented with the complaint of headache, abdominal pain, severe fever, catarrh, vomiting everything, bitter taste and watery stool. Parents noted progressive lethargy and reduced oral intake. No prior treatment except antipyretics. The child appeared acutely ill, febrile, dehydrated, and pale. Vital signs: high fever, tachycardia, and mild tachypnea. Abdominal exam showed right upper quadrant tenderness and mild hepatosplenomegaly. Neurological exam normal with no convulsions. She was diagnosed with severe malaria and enteric fever where treatment commenced with injection antimalarial, injection antibiotics and other supportive care. On the 3rd day, patient was stable and did well on the treatment given, no more fever and high temperature, headache stopped, vomiting ceased. She was discharged with some take home orals with instructions to take as prescribed and report any side effect. Patient is to return after 1 week for follow-up. The family remained grateful for the medical support from Helpster Charity.

The prognosis of severe malaria combined with enteric fever is guarded and depends heavily on early recognition and prompt treatment. If managed quickly with IV antimalarials, appropriate antibiotics, fluid and electrolyte correction, and supportive care, many patients can recover fully. However, the combination significantly increases the risk of complications such as severe anemia, septic shock, hepatic dysfunction, gastrointestinal bleeding, or altered consciousness. Delayed presentation, high parasite load, drug-resistant Salmonella, or coexisting malnutrition worsen outcomes. Children and immunocompromised patients are especially vulnerable. Close hospital monitoring and follow-up are critical for improving survival and reducing long-term complications.