Lilian A., 9

Lilian is an only child and currently in Grade Two. She lives with her parents, who depend on small-scale farming as their main source of livelihood, in a single-room mud-walled house with an iron-sheet roof. Lilian enjoys playing football with her friends and dreams of becoming a nurse. Lilian has a convulsive disorder and is on follow up. She had been well until she developed a persistent headache associated with marked fatigue, excessive sweating, generalized body weakness and repeated vomiting. Her condition subsequently worsened, and she developed convulsions, prompting her mother to take her to a nearby dispensary, where she received outpatient treatment and medication. Despite taking the prescribed medicines for two days, there was no improvement. Instead, Lilian became increasingly weak and lethargic, continued vomiting, had poor appetite and reduced feeding, and was unable to play or carry out her usual activities. Concerned by the persistent symptoms and previous convulsions, her mother took her to Siaya County Referral Hospital. She was assessed in casualty and subsequently admitted to the paediatric ward.

Lilian was diagnosed with severe malaria complicated by febrile convulsions, indicating significant systemic illness requiring urgent inpatient management. Recurrent seizures and severe malaria can lead to altered consciousness, hypoglycaemia, severe anaemia, neurological complications or death if untreated. Admission for appropriate antimalarial therapy, fever and seizure control, hydration and close monitoring was medically necessary. With prompt treatment and a good clinical response. Lilian’s prognosis is good.