4.1 Article

Cerebral Malaria Presenting With Shock in an Adolescent: A Case Report

Journal

CUREUS JOURNAL OF MEDICAL SCIENCE
Volume 14, Issue 9, Pages -

Publisher

CUREUS INC
DOI: 10.7759/cureus.29025

Keywords

hematuria; infection; shock; malaria; cerebral malaria

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This is a case report of a 15-year-old girl who presented with seizures and was diagnosed with cerebral malaria. The patient responded well to aggressive treatment with anti-malarial medications and antibiotics, and showed significant improvement after two weeks of treatment.
Cerebral malaria (CM) is a severe infection of the brain caused by the parasite Plasmodium falciparum. It is commonly found as a complication of infection traveling to the brain. CM has a poor prognosis unless promptly identified and treated. This case report describes a 15-year-old girl who suddenly started experiencing a tonic-clonic seizure while playing. At the time of arrival at the emergency department, her vital signs were consistent with shock. She had hepatomegaly on physical examination, a hallmark of malarial infection due to an immune response against the proliferation of the protozoa. Peripheral blood smear for malaria parasites was positive for P. falciparum and P. vivax. The patient was started on intravenous (IV) saline, IV phenytoin, and IV metoclopramide. She was also transfused with two units of packed red blood cells. The patient was subsequently diagnosed with CM. For most patients, the course of treatment includes aggressive therapy with anti-malarial medications. She was started on broad-spectrum antibiotics and anti-malarial medications. Following two weeks of treatment, her condition improved significantly and she was discharged.

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