Cerebral malaria and multi-organ dysfunction in an adult woman with Plasmodium falciparum infection imported from Cameroon: a case report

Abstract

Malaria is one of the most life-threatening parasitic diseases caused by the protozoa of the genus Plasmodium, occurring in the tropical and subtropical regions. Misdiagnosed infection can progress to a wide range of life-threatening pathologies, including severe anemia and cerebral malaria which can lead to death even few days after first symptoms appearance. Cerebral malaria is rare in adults and most cases are connected to children under 5 years old living in malaria endemic areas. In this article we describe cerebral malaria caused by the Plasmodium falciparum in a 45-year-old Polish patient, who traveled to Cameroon without any malaria prophylaxis. The patient had been treated in an intensive care unit because of multi-organ dysfunction as a result of the delayed malaria diagnosis. The presence of thrombocytopenia, anemia, metabolic acidosis, acute respiratory distress syndrome and multi-organ dysfunction involving liver, kidneys, and brain created an image of advanced severe malaria. Loss of consciousness, GCS 6, and the presence of asexual Plasmodium falciparum forms in blood films are the evidence of cerebral malaria. To avoid development of cerebral malaria, the illness should be diagnosed immediately. The cerebral malaria can occur also in adult healthy individuals. Appropriate treatment with intravenous artemisine can protect the patient from lifethreatening complications. Prolonged anemia after treatment can be a consequence of artemisine usage as well as a severe malaria sequel.