This is a 34-day-old female patient from an urban area of the municipality of Aristotle, who had consulted for intermittent fever, rhinorrhea and moist cough for five days before.
Pneumonia was diagnosed and outpatient treatment with amoxicillin and Dimetapp® was initiated.
Five days later, the patient was under control and the mother reported persistence of symptoms and generalized worsening.
For this reason she was referred to the reference hospital of the area.
Upon admission, a patient was admitted with hydrated axillary temperature of 37 °C, heart rate of 96 per minute and respiratory rate of 32 per minute.
Abdominal examination revealed hepatomegaly.
At this time the mother was re-interrupted, who reported that since the sixth month of pregnancy she had intermittent fever, subjective and mild, every two to three days.
With this background, thick smears were taken from her and her daughter, which were reported as positive for P. vivax.
Laboratory tests at diagnosis showed hemoglobin 6.0 g/dl, hematocrit 17.5%, leukocyte count 7.300/μl and platelet count 113,000/μl.
Under these circumstances it was decided to treat with chloroquine and perform transfusion of packed red blood cells.
On the third day of hospitalization, the patient continued to present positive thick smear, so it was considered that she had an early therapeutic failure and treatment with quinine sulfate was initiated.
On the second day of quinine administration, the thick drop was negative.
Four days later he was discharged.
