Severe Malaria Complicated by Symmetrical Peripheral Gangrene: A Case Study and Clinical Implications in Tropical Pediatrics

Context: Malaria remains a major cause of pediatric morbidity in Côte d'Ivoire. We present a rare case of severe malaria complicated by symmetrical peripheral gangrene, highlighting the diagnostic and therapeutic challenges in tropical pediatrics. Clinical case: A 4-year-old girl was admitted with peripheral cyanosis and acute infectious syndrome. Despite initial antimalarial treatment, she developed necrosis of the extremities. Examinations revealed severe malaria with severe anaemia (Hb: 4.9 g/dL) and marked inflammation (C-reactive protein: 276.2 mg/L). CT angiography did not show arterial obstruction. Management included blood transfusions, antibiotic therapy, heparin therapy, and local surgical care. Conclusions: This case study highlights the importance of early detection and a multidisciplinary approach in the management of severe malaria complications in tropical paediatrics. It highlights the complexity of the management of peripheral gangrene associated with severe malaria. Further research is needed to elucidate the vascular mechanisms involved and optimize therapeutic strategies in these complex cases. Keywords: symmetrical peripheral gangrene, severe malaria, tropical paediatrics, vascular complications.