title: Unusual presentations of malaria in children: an experience from a tertiary care center in North East India.
abstract: OBJECTIVE
  To identify cases of malaria with unusual presentations.
  
  
  METHODS
  The medical record of all the cases of malaria admitted to PICU and pediatric general ward from Oct 2006 to Sep 2009, were reviewed and cases with unusual presentations were identified. The study design was retrospective descriptive study.
  
  
  RESULTS
  Sixteen (10%) out of 162 malaria cases had unusual presentations - three had hemiplegia, two each with viral hepatitis-like presentation, acute abdomen, gastrointestinal bleed, generalized edema and hyperglycemia and one each with ptosis, severe headache and subacute intestinal obstruction-like presentation. Eleven cases had mixed parasitemia and two each with P. vivax and P. falciparum. One case was diagnosed on clinical grounds.
  
  
  CONCLUSIONS
  Malaria is a common disease, but both typical and atypical presentations deserve attention for early diagnosis and management.
authors.affiliation: Department of Pediatric Disciplines, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, Meghalaya, India. rashnadass@rediffmail.com
authors.forename: Rashna
authors.initials: R
authors.lastname: Dass
authors.forename: Himesh
authors.initials: H
authors.lastname: Barman
authors.forename: Saurabh Gohain
authors.initials: SG
authors.lastname: Duwarah
authors.forename: Nayan Mani
authors.initials: NM
authors.lastname: Deka
authors.forename: Pankaj
authors.initials: P
authors.lastname: Jain
authors.forename: Vivek
authors.initials: V
authors.lastname: Choudhury
mesh_terms: D000006:Abdomen, Acute / Q000469:parasitology; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D042241:Early Diagnosis; D004487:Edema / Q000469:parasitology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000469:parasitology; D006261:Headache / Q000469:parasitology; D006429:Hemiplegia / Q000469:parasitology; D006505:Hepatitis / Q000469:parasitology; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D006801:Humans; D006943:Hyperglycemia / Q000469:parasitology; D007194:India; D007223:Infant; D015278:Intensive Care Units, Pediatric; D007415:Intestinal Obstruction / Q000469:parasitology; D016778:Malaria, Falciparum / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D016780:Malaria, Vivax / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008499:Medical Records; D010963:Plasmodium falciparum / Q000302:isolation & purification*; D010966:Plasmodium vivax / Q000302:isolation & purification*; D012189:Retrospective Studies