Unusual presentations of vivax malaria: a report of two cases.

Malaria contributes to significant morbidity and mortality in the developing countries of the tropics. World Health Organization (WHO) has estimated [WHO malaria news release, year 2010] that about 250 million cases of malaria occur every year worldwide, causing 8,60,000 deaths. Malaria caused by Plasmodium falciparum accounts for majority of complications and deaths due to malaria. The symptoms of malaria are non-specific. A significant minority of patients of malaria in endemic areas may present with atypical clinical manifestations, thereby mimicking other illnesses and leading to diagnostic confusion as well as delay in treatment1. This may lead to complications or even death. Complicated malaria may closely mimic other commonly prevalent infections like enteric fever, leptospirosis, dengue haemorrhagic fever, acute viral hepatitis, viral meningoencephalitis, scrub typhus and severe sepsis of obscure origin. Here, we report two cases of vivax malaria with unusual presentations—one with acute gastroenteritis without fever at presentation and the other with fever, generalized convulsive status epilepticus and isolated bilateral sixth cranial nerve palsy, as cerebral malaria.