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Congenital malaria — DTM&H MCQ

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EasyMalariaCongenital malariaDTM&H

A 3-week-old infant born in the UK to a mother recently arrived from Cameroon presents with fever, anaemia and hepatosplenomegaly. The baby has not travelled and blood culture is negative at 24 hours. What is the most likely diagnosis?

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Correct answer: D — Congenital malaria

Congenital malaria is the single best answer because maternal parasitaemia can transmit malaria transplacentally and present with fever, anaemia and splenomegaly in early infancy. Neonatal enterovirus is plausible in a related presentation, but it is less appropriate because it does not fit the key discriminator in this vignette. The teaching point is that lack of infant travel does not exclude malaria when maternal exposure is relevant.

Reference: WHO Guidelines for malaria, 2025; UKHSA Malaria prevention guidelines for travellers from the UK, 2025; CDC Yellow Book 2026