Thrombocytopenia in Plasmodium vivax infected children.

Malaria is endemic in 91 countries. Maximum mortality is associated with Plasmodium falciparum malaria and more than 8,00,000 deaths occur in children less than five years of age1. P. falciparum usually presents with severe or complicated malaria, which presents as fever, chills, shock, hepatic failure, renal failure, cerebral malaria and malarial sepsis. It leads to 100% mortality if left untreated. Simple malaria presents with fever, chills and splenomegaly and is usually caused by P. vivax, P. malariae and P. ovale. Thrombocytopenia is a usual phenomenon in complicated malaria and is uncommonly seen in P. vivax. Thrombocytopenia has been found in 3.6% of adult patients with P. vivax from India2 and only one case of severe malaria has been reported in a child3. However, in 2004 during the rainy season, we had six children who presented with fever and thrombocytopenia due to vivax malaria, which was never seen in previous years suggesting a change in the clinical presentation of the disease. We present these six cases with discussion on thromobocytopenia in vivax malaria.