Less Common Protozoan and Helminth Infections

Congenital Malaria, an Important Differential Diagnosis to Consider When Evaluating Febrile Infants of Immigrant Mothers

“…Therefore, congenital malaria is more commonly observed in newborn infants of malaria-infested women who have low levels of immunity because they were not raised in a malariaendemic area or who migrated from a malaria-endemic to a malaria-free area with subsequent loss of immunity from lack of exposure. 19 There is no consensus on the definition of congenital malaria, yet, in endemic countries, congenital malaria is diagnosed when the parasite is seen on the infant's peripheral blood smear during the first week of life. 17 Although we were unable to demonstrate malarial parasites in the maternal peripheral circulation with routine microscopy at the time of presentation, the diagnosis of congenital malaria in our patient at age of 26 days was established by the presence of P. vivax on the peripheral smear, with a negative history of vector exposure postnatally (Fig.…”

“…Malaria occurring during the first few months of life, frequently complicated by other illnesses such as pneumonia, septicemia, and diarrhea, has been described from developing countries. 19,25 Those secondary infectious complications have been commonly attributed to a relative state of immune suppression secondary to infestation with malarial parasites. 26 Chloroquine-resistant P. vivax infections have been reported in the Americas, 27 but not from Honduras; hence, our patient responded well to therapy with chloroquine and antibiotic therapy for presumed concomitant bacterial pneumonia.…”

Neonatal Cholestasis due to Plasmodium Vivax Malaria

“…The disease most commonly presents during the first 4 wk of life but its onset can be delayed for few months. Neonatal Cholestasis due to congenital malaria improves in 1 wk while neonatal cholestasis due to other causes may take 4-6 wk [3,5].…”

Evolutionary–developmental perspectives on immune system interactions among the pregnant woman, placenta, and fetus, and responses to sexually transmitted infectious agents

“…Other STI agents T. vaginalis provides an important lesson regarding the possible effect of hormones on the adaptation of infectious agents to the female genital econiche. Although infrequently acquired from the mother, the protozoa may replicate in the female newborn's vagina causing a discharge for a short period, while still under the influence of transplacentally transmitted maternal estrogen (this hormone is important for the cornification of the vaginal mucosa that allows replication of the Trichomonas) 146,165 . Phylogenetically, T. vaginalis differs markedly from the T. foetus of cows that causes abortions 39 .…”