A Case of Mixed Infected Cerebral Malaria

ABSTRACT

Cerebral malaria means that the patient with demonstrable asexual forms of Plasmodium falciparum in peripheral blood smear who have disturbed mental state and in whom other causes of encephalopathy, such as bacterial, fungal, or viral meningoenoephalitides, drug intoxications other metabolic disease have been excluded. In cerebral malaria, the mortality rate is up to 30% and most of death is within 96 hours, so is known as neurological emergency that urgent treatment should be required. A 42 years old male patients admitted our emergency room with spiking fever 2 days before admission and drowsy mental state at the moming of admission day. The patient traveled in Africal 2 weeks ago. On physical and neurologic examination, the hepatomegaly, drowsy mental state and divergent eyeball was observed. Brain CT scan was normal but pulmonary edema was seen in chest PA and mild increased protein(76mg/dl) was observed in spinal tapping. In peripheral blood smear, severe thrombocytopenia and trophozoa of ring form and band form wer found so diagnosed as mixed infected cerebral malaria. The patient was started the treatment of chloroguine and tetracycline and recovered 2 weeks after treatment. Cerebral malaria should be once considered as differential diagnosis in patients with unknown origin fever and mental confusion in intemalized society like modem.