Abstract
Introduction:Malaria is a serious parasitic infection, with suggestive symptoms in endemic regions. In Tunisia, a non-malarial country, this parasitosis is a diagnostic challenge, particularly in the absence of any notion of travel to an endemic region.
Our aim is to highlight the contribution of scattergrams provided by hematology analyzers in the diagnostic orientation of malaria through the case of an infant suffering from Plasmodium falciparum.
Case presentation: A 2-year-old male infant was admitted for management of prolonged fever with hepatosplenomegaly, following an episode of gastroenteritis the previous week. The blood count showed anemia at 5.8 g/dl normochromic normocytic regenerative, thrombocytopenia at 79000/mm3. The White Cell Differential channel leukocyte scattergram showed an additional purple cloud below that of eosinophils. The reticulocyte scattergram showed a double population of red blood cells. Blood smear examination showed P. falciparum trophozoites and gametocytes, with 6% parasitaemia. The diagnosis of lymphohistiocytosis hemophagocyticosis secondary to malaria was made in view of the fever, splenomegaly, bicytopenia, hyperferritinemia at 855.4 μg/L and hypertriglyceridemia at 6.7 mmol/L.
Conclusion: Although blood smear and thick drop examination remain the reference methods, scattergrams provided by certain hematology analyzers can guide the diagnosis of malaria.
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