Life-threatening Plasmodium falciparum parasitemia, in an infant returning from the tropics

Severe falciparum malaria is a polymorphous life-threatening disease. Hyperparasitemia is rare among non-immune children returning from tropical areas. CARE REPORT: We report a case of an infant returning from Ivory Coast who presented with fever, prostration and marked thrombocytopenia (22,000 platelets/mm(3)). Blood slide showed Plasmodium falciparum ring forms. Parasite density dramatically increased from 1.7% to 45%, and the child developed several features of severe malaria, according to WHO definition. In this non-immune infant, prostration and thrombopocytopenia seemed to be earlier predictors of severity than hyperparasitemia and other WHO criteria, which have not been yet validated in travelling children.