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LETTER TO THE EDITOR
Year : 2012  |  Volume : 7  |  Issue : 3  |  Page : 241-242
 

Author reply


1 Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
2 Department of Pathology, University College of Medical Sciences and associated Guru Teg Bahadur Hospital, New Delhi, India

Date of Web Publication25-Jan-2013

Correspondence Address:
Girish Chandra Bhatt
20/19, 3rd floor, Old Rajendra Nagar, New Delhi - 110 060
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Bhatt GC, Sharma T. Author reply. J Pediatr Neurosci 2012;7:241-2

How to cite this URL:
Bhatt GC, Sharma T. Author reply. J Pediatr Neurosci [serial online] 2012 [cited 2019 Apr 23];7:241-2. Available from: http://www.pediatricneurosciences.com/text.asp?2012/7/3/241/106496


Dear Sir,

We appreciate the interest shown in our case report [1] and the opportunity to clarify the queries raised by the authors. [2]

While writing case report, one has to follow the journal's guidelines and it becomes difficult to provide very minute details such as date of admission and discharge of the patient. This patient was admitted to our hospital in July 2007 [3] and rapid test for malaria was done on the 2 nd day of admission (G0161 CareStart Malaria HRP2/PLDH (Pf/Pv) COMBO). We completely agree that the 'gold standard' is microscopy with a thin and thick smear for which National Vector Control Programme would have been more suitable.

P. vivax and falciparum are the most prevalent species that cause malaria, and mixed infection of the two species are common and frequently recorded in the field survey, [4] but are underreported. A study revealed that 10.5% of the patients diagnosed with P. vivax alone actually harbored P. facliparum as well. [5] Indeed, the danger of misdiagnosing mixed infection as a single infection has been noticed by Knowles and White [6] who described the 'flexible stopping rule', the tendency of the worker to stop examining a blood film once parasite have been found.

P. falciparum disease severity ranges from severe and complicated malaria to mild and uncomplicated, to asymptomatic. [7] In our case, we speculated Japanese Encephalitis Virus (JEV) as a cause of acute encephalitic syndrome (AES) as suggested by the clinical course of the disease. However, at times it becomes very difficult to clinically differentiate between the two due to overlapping clinical presentations.

 
   References Top

1.Bhatt GC, Sharma T, Kushwaha KP. Concurrent infection of Japanese encephalitis and mixed plasmodium infection. J Pediatr Neurosci 2012;7:52-4.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Arya SC, Kalra NL. Concurrent infection of Japanese encephalitis and mixed plasmodium infection. J Pediatr Neurosci 2012;7:240-2.  Back to cited text no. 2
    
3.Bhatt GC, Bondre VP, Sapkal GN, Sharma T, Kumar S, Gore MM, et al. Changing clinico-laboratory profile of encephalitis patients in the eastern Uttar Pradesh region of India. Trop Doct 2012;42:106-8.  Back to cited text no. 3
    
4.Krudsood S, Wilairatana P, Mason DP, Treeprasertsuk S, Singhasivanon P, Looareesuwan S. Hidden Plasmodium falciparum infections. Southeast Asian J Trop Med Public Health 1999;30:623-4.  Back to cited text no. 4
    
5.Mason DP, Krudsood S, Wilairatana P, Viriyavejakul P, Silachamroon U, Chokejindachai W, et al. Can treatment of P. vivax lead to a unexpected appearance of falciparum malaria? Southeast Asian J Trop Med Public Health 2001;32:57-63.  Back to cited text no. 5
    
6.Knowles R, Senior W R, Das GB. Studies in the parasitology of malaria. Indian Med Res Meta 1930;18:80-6.  Back to cited text no. 6
    
7.WHO. Severe falciparum malaria. World Health Organization, Communicable Diseases Cluster. Trans R Soc Trop Med Hyg 2000;94:S1-90.  Back to cited text no. 7
    




 

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