Spontaneous subdural empyema in malaria: a case study

Malaria is one of the most common diseases in tropical countries. In our country, malaria is endemic in some parts of south and east. Cerebral malaria is usually a diffuse symmetric encephalopathy with focal signs being unusual. We present a two-year old girl with fever and seizure while undergoing treatment for malaria. Imaging disclosed acute subdural empyema. Investigations revealed anemia, thrombocytopenia and positive peripheral blood smear for vivax malaria. Treatment involved surgical evacuation of the subdural empyema, oral chloroquin and antibiotics. This is the third case report of spontaneous subdural empyema in complicated malaria and highlights a rare but surgically manageable complication

Cerebral malaria with reversible hemiplegia failed to response to parenteral chloroquine and fansidar in Yemen

Severe Cerebral Malaria is a serious, life threatening medical emergency, which necessitates immediate hospital management. Quinine and tetracycline are well recognized for its treatment after the appearance of chloroquine, and pyrimethamine-Sulfadoxine resistance [Fansidar] in Africa [East, West], south east Asia, and south and central America. Focal neurological complications such as hemiplegia, cortical blindness or ataxia.etc. are rare. The high risk people are young children 6 months-3 years old, pregnant ladies [primigravida more], nonimmune person or immunocompromized person. Severe Falciparum malaria can present with few or many manifestations in a predisposed person. This case report of 27 years multiparous lady, two weeks post delivery who had headache, fever sweating and brought into hospital with unarousable coma and right sided hemiplegia, hypotension and anemia. She did not respond to parenteral Chloroquine and Fansidar, but recovered full consciousness and movement of quinine HCL and Teracycline