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Figure 7 | Malaria Journal

Figure 7

From: Vivax malaria in an Amazonian child with dilated cardiomyopathy

Figure 7

Patient history with major clinical events, diagnosis and possible causal relationship. The patient was admitted when she was 11 months old with respiratory symptoms and vivax malaria. She was treated and discharged home two days later without symptoms. After two months she started to have increasing dyspnoea and respiratory distress and was admitted again at 13 months old with a dilated cardiomyopathy and negative thick blood smears. During admission, there was an initial improvement of dyspnoea, but after a few weeks the dyspnoea worsened and she developed fever, with a positive smear to P. vivax. After malaria treatment with chloroquine and primaquine, there was important improvement of respiratory distress and fever. Positive serology for CMV suggest that she had a CMV-induced myocarditis around 11 months of age, progressing to symptomatic dilated cardiomyopathy, and later developing relapsing vivax malaria, with a severe clinical presentation.

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