An extrapulmonary shunt through the ASD or PDA causes a R-L shunt which cannot be reversed with O2 administration and typically presents in a child with no tachypnea Cyanotic heart disease presents with similar features. Although pulmonary hypertension may be associated with MAS, there is respiratory distress in this disease. A form of CLD in VLBW infants not treated with mechanical ventilation presenting after 1 week of age with insidious onset of tachypnea and hypoxia 7. Common infections are bacterial, although susceptibility to Giardiasis, Pneumococcal chronic conjunctivitis, Hep A viruses and ECHO viruses is typical. Skin, nails and mucous membranes are affected with candidal infection.
Neutrophil chemotaxis is impaired.
Although there are many vaccines available including against the trophozoites and sporozoites, there is no effective vaccine yet. P falciparum is resposible for cerebral malaria and is the most dangerous of the four types of parasites There are pockets of chloroquine sensitivity in Africa, especially Northern areas. In the Sub-Saharan regions, resistance is common. All ages of red cells are affected leading to the extreme severity of the disease and hemolysis. Due to an exoerythrocytic cycle, there are hypnozoites in the liver cells which may cause relapses unless treated with primaquin 9.