Cerebral malaria: A life-threatening complication

摘要

A 25-year-old man was admitted to our hospital with complaints of hematuria, abdominal pain, vomiting, and high fever. Upon admission, patient’s fever was 38.6 °C, platelet count was 22000 × 109 /L, hemoglobin level was 100 g/L, and retinal hemorrhages were observed on ophthalmoscopic examination. The patient’s history revealed that he had traveled to Chad six days prior. With the initial diagnosis of malaria, a blood smear was performed to identify the malaria parasites. The patient was started on medical treatment. However, on the fourth day of admission, the patient showed neurological signs and confusion. With suspicion of cerebral involvement, brain diffusion-weighted magnetic resonance imaging (DW-MRI) was performed. DW-MRI (Figure 1) demonstrated restricted diffusion in the bilateral subcortical areas and splenium of the corpus callosum. The patient was treated with antiepileptic, antimalarial, and antiaggregant and anticoagulant drugs. On the eleventh day of admission, the patient was discharged with full recovery.