Handling cerebral malaria patient with limited resources: a case report
DOI:
https://doi.org/10.36216/jpd.v5i2.149Keywords:
cerebral malaria, emergency, Plasmodium falciparum, artesunate, limited resourcesAbstract
Cerebral malaria is an emergency condition. All patients with Plasmodium falciparum infection followed by neurological symptoms should be treated as cerebral malaria. The pathogenesis of cerebral malaria is caused by the damage of blood vessels endothelium due to parasites sequestration, production of pro-inflammatory cytokines and leakage of blood vessels which can cause brain hypoxia. The proper management is needed, however this become quiet challenging issue in the setting of limited resouces. We report a case of a 35 year old patient presenting with a loss of consciousness accompanied by shivering fever for 5 days. On examination of the peripheral blood smear, the Plasmodium falciparum was found. The patient was later diagnosed as cerebral malaria and treated with anti-malarial drugs. The fifth day of treatment the patient has fully alert. In the next day, the patient was allowed to go home. The management of cerebral malaria is challenging, particularly in the area with limited resources.
Downloads
References
Harijanto PN. Malaria. Buku Ajar Ilmu Penyakit Dalam. Jilid III, edisi IV. Fakultas Kedokteran Universitas Indonesia. Jakarta, 2006;1754-60.
Arcelia F, Asymida F, F M Lubis N, Pasaribu AP. Severe falciparum malaria: A case report. IOP Conf. Ser.: Earth Environ. Sci. 2018;125:012021.
WHO. World Malaria Report 2015. France; 2015. Available at: www.who.int
WHO. World Malaria Report 2019. Switzerland: World Health Organization. pp. xii–xiii, 4–10.
Mundhra S, Pamar U, Shukla D. A prospective study to identify the co-relation of a disease severity of complicated malaria & clinical outcome. Paripex-Ind J res. 2016.12;24:7.
Newton CR, Hien TT, White N. Cerebral malaria. J Neurol Neurosurg Psychiatry. 2000;69(4);433-441.
Miller LH, Baruch DI, Marsh K, Doumbo OK. The pathogenic basis of malaria. Nature. 2002;415(6872):673-679.
Idro R, Marsh K, John CC, Newton CR. Cerebral malaria: mechanisms of brain injury and strategies for improved neurocognitive outcome. Pediatric Res. 2010;68(4):267-274.
World Health Organization. Severe falciparum malaria. World health organization, communicable diseases cluster. Trans R Soc Trop Med Hyg. 2000;94 Suppl 1:S1-90.
Misra UK, Kalita J, Prabhakar S, Chakravarty A, Kochar D, Nair PP. Cerebral malaria and bacterial meningitis. Ann Indian Acad Neurol. 2011;14(Suppl 1):S35–39.
Mishra SK, Newton CR. Diagnosis and management of the neurological complications of falciparum malaria. Nat Rev Neurol. 2009;5(4):189–198.
Laurent Rnia, Howland SW, Claser C, Grunner AC, Suwanarusk, Teo Teck Hui et al. Cerebral malaria: Mysteries at the blood-brain barrier. Virulence. 2012;3(2):193–201.
Kementrian Kesehatan Republik Indonesia. Pedoman Tatalaksana Malaria. Kemenkes RI; 2013.
Elyazar IRF, Gething PW, Patil AP, Rogayah H, Kusriastuti R, Wismarini DM et al. Plasmodium falciparum endemicity in Indonesia in 2010. PLoS ONE 6(6): e21315.
Aru WS, Bambang S, Idrus A, Marcellus SK, Siti S. Buku Ajar Ilmu Penyakit Dalam Jilid III. Interna Publishing; 2009.
Zapata CH, Trujillo SB. Malaria cerebral. IATREIA. 2003;16(3):202–216.
Cabrales P, Zanini GM, Meays D, Frangos JA, Carvalhon LJM. Murine Cerebral Malaria associated with vasospasm-like microcirculatory dysfunction and survival upon rescue treatment is markedly increased by nimodipine. Am J Pathol. 2009;176:1306-1315
Ngoungou EB, Preux PM. Cerebral malaria and epilepsy. Epilepsia. 2008;49(Suppl. 6):19-24.
Patel DN, Pradeep P, Surti MM, et al. Clinical manifestations of complicated malaria – an overview. JIACM. 2003;4(4):323–31
Ndreu A, Hajdari D, Ndoni A, et al. Epidemiological, clinical and therapeutic aspects of cerebral malaria imported in Albania. J Infect Dev Ctries. 2016;10(2):190–194.
Kementerian Kesehatan Republik Indonesia. Peraturan menteri kesehatan Republik Indonesia nomor 5 tahun 2013 tentang pedoman tata laksana malaria. Jakarta: Kemenkes RI; 2013.
Efendi F, Fachrizal A, Mahendra Tri AS. Studi komparasi perilaku masyarakat dan kondisi lingkungan pada kejadian demam berdarah dengue di daerah KLB dengan non KLB di Surabaya. Jurnal Ilmiah Mahasiswa Kedokteran Indonesia. 2006;1(2):10-6.
Downloads
Published
Issue
Section
License
Copyright (c) 2021 Jurnal Penyakit Dalam Udayana
This work is licensed under a Creative Commons Attribution 4.0 International License.