Unusual Presentation of Malaria As Tetany: A Case Report (Case Study‪)‬

Malaria is a major disease of public health importance with a high morbidity and mortality. Various atypical presentations of malaria have been described in literature (1). Physicians should be aware of the different ways in which malaria can present to ensure its early diagnosis and treatment. We herein describe an unusual presentation of malaria as tetany and discuss in brief regarding calcium, phosphate and magnesium metabolism in malaria. Case report: A 12-year old Indian boy hailing from Mumbai was admitted in Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India with fever for four days and painful, intermittent muscle spasm of the left foot since one day. Fever was high-grade, intermittent and associated with rigors. There was no history of loss of consciousness, altered sensorium, paresthesia, trauma, drug intake or convulsion. His past, development and family history was normal. His dietary history was normal with an adequate calcium intake. On admission, the child was febrile with a heart rate of 140/min, respiratory rate of 28/min and blood pressure of 100/78 mm Hg. There was pallor and mild icterus on examination. Chvostek sign and Trousseau sign were negative. Intermittent muscle spasm of the left foot was seen on examination. The liver was tender and palpable 4 cm below the right costal margin with a span of 7 cm. The spleen was palpable 3 cm below the left costal margin. On central nervous examination, he was conscious and well-oriented in time, place and person. His motor and sensory examination was normal. Superficial reflexes were normal with bilateral brisk knee and ankle reflexes. There were no cerebellar or meningeal signs. Other systems were normal.