Intravenous artesunate for transfusion-transmitted plasmodium vivax malaria in a preterm neonate

Abstract

Transfusion-transmitted malaria (TTM) in neonates is rare. TTM can occur in both endemic and nonendemic areas because the current tests used to screen the donor blood for malaria are unreliable when there is low parasitemia. Malaria must be considered as an impor- tant differential diagnosis for neonatal sepsis after exchange trans- fusion. Management strategy in TTM in the neonatal period is not standardized; exchange transfusion is often considered. We used in- travenous artesunate in a case of severe malaria caused by Plasmo- dium vivax in a 30-week preterm neonate after packed red blood cell transfusion on day 19 of life. This is the first clinical report of par- enteral artesunate successfully used in the neonatal period. We em- phasize the need for further investigation of the safety and efficacy of intravenous artesunate in the treatment of severe neonatal malaria.