Cerebral malaria presenting as nonconvulsive status epilepticus: a case report
Abstract Background Malaria is an infectious malady caused by Plasmodium parasites, cerebral malaria standing out as one of its most severe complications. Clinical manifestation include elevated body temperature, loss of consciousness, and seizures. However, reports of cerebral malaria presenting as...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | Malaria Journal |
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| Online Access: | https://doi.org/10.1186/s12936-024-04908-z |
| _version_ | 1797247469729349632 |
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| author | Xingguo Wu Ningxiang Qin Fahang Yi Jing Wang Xia Yan Liang Wang |
| author_facet | Xingguo Wu Ningxiang Qin Fahang Yi Jing Wang Xia Yan Liang Wang |
| author_sort | Xingguo Wu |
| collection | DOAJ |
| description | Abstract Background Malaria is an infectious malady caused by Plasmodium parasites, cerebral malaria standing out as one of its most severe complications. Clinical manifestation include elevated body temperature, loss of consciousness, and seizures. However, reports of cerebral malaria presenting as nonconvulsive status epilepticus are extremely rare. The case presented involves psychiatric symptoms, with the electroencephalogram indicated nonconvulsive status epilepticus associated with cerebral malaria. Case presentation A 53-year-old male, was urgently admitted, due to confusion and abnormal behaviour for 10 h. The patient returned to China after developing a fever while working in Tanzania two months ago. The blood smear revealed Plasmodium vivax and Plasmodium falciparum, and he was diagnosed with malaria. He recovered following anti-malarial treatment. After admission, the patient was confused, unable to communicate normally, and unwilling to cooperate with the physical examination. Plasmodium was not found in the blood smear, but the DNA sequence of P. falciparum was discovered using metagenomic next-generation sequencing of cerebrospinal fluid. Brain MRI revealed no significant abnormalities. Continuous electroencephalogram monitoring revealed that the patient had non-convulsive status epilepticus, which was treated with diazepam and levetiracetam. The patient had normal consciousness and behaviour. He received anti-malarial treatment for two weeks and fully recovered. Conclusions This case demonstrates that nonconvulsive status epilepticus can be a manifestation of cerebral malaria. It is imperative for attending physicians to heighten vigilance when encountering patients with a history of travel to malaria-endemic regions or a prior malaria infection, especially in the presence of unusual clinical presentations. |
| first_indexed | 2024-04-24T19:59:12Z |
| format | Article |
| id | doaj.art-5dd6b1106cdb48149a8b150970095553 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-04-24T19:59:12Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-5dd6b1106cdb48149a8b1509700955532024-03-24T12:11:03ZengBMCMalaria Journal1475-28752024-03-012311510.1186/s12936-024-04908-zCerebral malaria presenting as nonconvulsive status epilepticus: a case reportXingguo Wu0Ningxiang Qin1Fahang Yi2Jing Wang3Xia Yan4Liang Wang5Department of Neurology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Neurology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Neurology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Neurology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Neurology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Neurology, The First Affiliated Hospital of Chongqing Medical UniversityAbstract Background Malaria is an infectious malady caused by Plasmodium parasites, cerebral malaria standing out as one of its most severe complications. Clinical manifestation include elevated body temperature, loss of consciousness, and seizures. However, reports of cerebral malaria presenting as nonconvulsive status epilepticus are extremely rare. The case presented involves psychiatric symptoms, with the electroencephalogram indicated nonconvulsive status epilepticus associated with cerebral malaria. Case presentation A 53-year-old male, was urgently admitted, due to confusion and abnormal behaviour for 10 h. The patient returned to China after developing a fever while working in Tanzania two months ago. The blood smear revealed Plasmodium vivax and Plasmodium falciparum, and he was diagnosed with malaria. He recovered following anti-malarial treatment. After admission, the patient was confused, unable to communicate normally, and unwilling to cooperate with the physical examination. Plasmodium was not found in the blood smear, but the DNA sequence of P. falciparum was discovered using metagenomic next-generation sequencing of cerebrospinal fluid. Brain MRI revealed no significant abnormalities. Continuous electroencephalogram monitoring revealed that the patient had non-convulsive status epilepticus, which was treated with diazepam and levetiracetam. The patient had normal consciousness and behaviour. He received anti-malarial treatment for two weeks and fully recovered. Conclusions This case demonstrates that nonconvulsive status epilepticus can be a manifestation of cerebral malaria. It is imperative for attending physicians to heighten vigilance when encountering patients with a history of travel to malaria-endemic regions or a prior malaria infection, especially in the presence of unusual clinical presentations.https://doi.org/10.1186/s12936-024-04908-zCerebral malariaNonconvulsive status epilepticusElectroencephalogram |
| spellingShingle | Xingguo Wu Ningxiang Qin Fahang Yi Jing Wang Xia Yan Liang Wang Cerebral malaria presenting as nonconvulsive status epilepticus: a case report Malaria Journal Cerebral malaria Nonconvulsive status epilepticus Electroencephalogram |
| title | Cerebral malaria presenting as nonconvulsive status epilepticus: a case report |
| title_full | Cerebral malaria presenting as nonconvulsive status epilepticus: a case report |
| title_fullStr | Cerebral malaria presenting as nonconvulsive status epilepticus: a case report |
| title_full_unstemmed | Cerebral malaria presenting as nonconvulsive status epilepticus: a case report |
| title_short | Cerebral malaria presenting as nonconvulsive status epilepticus: a case report |
| title_sort | cerebral malaria presenting as nonconvulsive status epilepticus a case report |
| topic | Cerebral malaria Nonconvulsive status epilepticus Electroencephalogram |
| url | https://doi.org/10.1186/s12936-024-04908-z |
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