Alert for Imported Malaria in Non-Endemic Areas: A Case Report of Atypical Falciparum Malaria in a Young Child and Diagnostic Experience

Background: Although China has eliminated indigenous malaria, imported cases, particularly among young and middle-aged workers returning from Africa, constitute a major challenge for current epidemic prevention and control. In contrast, imported malaria in children is extremely rare and often subject to diagnostic delays in non-endemic areas due to atypical clinical presentations. Case presentation: We report a case of a 2-year-11-month-old boy who returned from Sudan, a malaria-endemic region, presenting with fever and diarrhea as the initial symptoms. The case was identified by the laboratory through the blood routine re-examination rules, crucially informed by the patient’s epidemiological history. The diagnosis was ultimately confirmed as Plasmodium falciparum malaria by rapid diagnostic testing and microscopic examination. Conclusion: This diagnostic pathway exemplifies a closed-loop model of “clinical suspicion → targeted laboratory testing → definitive pathogen identification.” It provides a practical framework for the early detection and diagnosis of pediatric imported malaria with atypical presentations in non-endemic areas.