Sudden infant death due to imported malignant malaria in Europe

Abstract

Malaria is an infectious disease caused by the Plasmodium spp. protozoa with a high mortality rate in the endemic areas. However, with the modern globalization, there is a case increase of imported malaria, also in non-endemic European regions. Infants are the most vulnerable subjects, where the disease can occur with a misleading symptomatology, favoring a delayed diagnosis. We report the first case in literature of sudden infant death, due to imported malignant malaria ex Pakistan, in a 4-month-old female, died in Italy, her native country, 2 weeks after a holiday spent in Pakistan, the land of her parents, notoriously at high malarial endemicity. The severe congestion of microvessels in all organs, especially brain, owing to the parasitized erythrocytes, has played a crucial role in the fatal pathogenic mechanism. A careful travel anamnesis is deem necessary to prevent this rare, but possible, form of sudden infant death and their related forensic sequelae.