Pediatric Malaria Differential Diagnoses

  • Author: Parang N Mehta, MD; Chief Editor: Russell W Steele, MD   more...
 
Updated: May 17, 2012
 
 

Diagnostic Considerations

Severe and complicated malaria can be rapidly fatal, and wasting time is dangerous. Prompt diagnosis and immediate treatment with a drug known to be effective in the area where the malaria was acquired can be lifesaving. The presentation is varied and may suggest other conditions, such as meningitis, encephalitis, or epilepsy. Thus, cerebral malaria, and other forms of severe malaria, should be considered in the differential diagnosis of a febrile neurologic or other serious illness if a history of residence or travel through a malarious area exists.

Conditions to consider in the differential diagnosis of malaria include the following:

  • Ascending cholangitis
  • Enteric fever
  • Encephalitis
  • Heatstroke
  • Hepatitis
  • Lobar pneumonia
  • Pharyngitis
  • Viral pneumonia
  • Tonsillitis
  • Pelvic inflammatory disease
  • Bacteremia
  • Salmonella infection
  • Sinusitis
  • Tetanus
  • Giardiasis
  • Aseptic meningitis
  • Bacterial meningitis
  • Otitis media
  • Yellow fever

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Parang N Mehta, MD  Consulting Staff, Department of Pediatrics, Mehta Hospital, Surat, India

Parang N Mehta, MD is a member of the following medical societies: Indian Academy of Pediatrics and Indian Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Gary J Noel, MD  Professor, Department of Pediatrics, Weill Cornell Medical College; Attending Pediatrician, New York-Presbyterian Hospital

Gary J Noel, MD is a member of the following medical societies: Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

References
  1. World Health Organization. WHO Fact Sheet on Malaria. Fact Sheet No 94. World Health Organization. Available at http://www.who.int/mediacentre/factsheets/fs094/en/print.html. Accessed June 29, 2007.

  2. Ezeamama AE, Spiegelman D, Hertzmark E, Bosch RJ, Manji KP, Duggan C, et al. HIV Infection and the Incidence of Malaria Among HIV-Exposed Children from Tanzania. J Infect Dis. May 2012;205(10):1486-94. [Medline].

  3. Idro R, Marsh K, John CC, Newton CR. Cerebral Malaria; Mechanisms Of Brain Injury And Strategies For Improved Neuro-Cognitive Outcome. Pediatr Res. Jul 2 2010;[Medline].

  4. Scott JA, Berkley JA, Mwangi I, et al. Relation between falciparum malaria and bacteraemia in Kenyan children: a population-based, case-control study and a longitudinal study. Lancet. Oct 8 2011;378(9799):1316-23. [Medline].

  5. [Best Evidence] Abdulla S, Oberholzer R, Juma O, et al. Safety and immunogenicity of RTS,S/AS02D malaria vaccine in infants. N Engl J Med. Dec 11 2008;359(24):2533-44. [Medline].

  6. The RTS,S Clinical Trials Partnership. First results of phase 3 trial of RTS,S/AS01 malaria vaccine in African children. N Engl J Med. 2011/Oct;365:[Full Text].

  7. White NJ. A vaccine for malaria (editorial). N Engl J Med. 2011/Oct;365:[Full Text].

  8. Griffith KS, Lewis LS, Mali S, Parise ME. Treatment of malaria in the United States: a systematic review. JAMA. May 23 2007;297(20):2264-77. [Medline]. [Full Text].

  9. Sinclair D, Donegan S, Lalloo DG. Artesunate versus quinine for treating severe malaria. Cochrane Database Syst Rev. Mar 16 2011;3:CD005967. [Medline].

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The various stages of Plasmodium vivax as observed on Giemsa staining of a peripheral blood smear.
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