<i>Plasmodium vivax</i>Malaria Presenting with Multifocal Hemorrhagic Brain Infarcts in a School-going Child

Rathia, Santosh Kumar; Sankar, Jhuma; Kandasamy, Devasenathipathy; Lodha, Rakesh

doi:10.1093/tropej/fmw007

Cited by 4 publications

(6 citation statements)

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“…En once de ellos las manifestaciones neurológicas fueron múltiples convulsiones, y siete además tuvieron signos de afección de primera motoneurona, sin evidencia de hemorragia o papiledema (10) . Sin embargo, en un reporte de caso del mismo país en 2016, un niño de 10 años presentó hemorragia multifocal con compromiso profundo del sensorio y secuelas neurológicas como el incremento del tono muscular y estado de conciencia mínimo (2) .…”

Section: Discussionunclassified

“…En la gran mayoría de casos reportados, el diagnóstico inicial se efectuó por gota gruesa y extendido en lámina de sangre periférica con la observación directa del parásito, y la confirmación de la especie a través de técnicas moleculares (PCR) (1,2,(11)(12)(13) . La respuesta al tratamiento con artesunato y clindamicina fue óptima, cabe resaltar que el uso de artesunato es una constante en el tratamiento por malaria grave (1,2,(11)(12)(13) con variación de la segunda droga, pudiendo ser esta clindamicina (2) , doxiciclina (1,13) , lumefantrina (12) e, inclusive, quinina y primaquina, sin el uso de artesunato (14) , todos estos esquemas han demostrado mejoría del paciente y negativización del parásito en la sangre.…”

Section: Discussionunclassified

“…La malaria cerebral (MC) es una complicación de la malaria grave, caracterizada por encefalopatía difusa asociada a coma y convulsiones, la mayoria de los casos reportados son por infección de Plasmodium falciparum en niños (1) . Generalmente, Plasmodium vivax solo causa paludismo no complicado; sin embargo, se han reportado algunos casos de malaria complicada, pero es poco usual la afectación cerebral (2) . Los casos de malaria por Plasmodium vivax representan el 81% de todos los casos diagnosticados en el Perú, con una incidencia de 42,68 por cada 100 mil habitantes y mayor frecuencia en hombres (54%) (3,4) .…”

Section: Introductionunclassified

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Malaria cerebral con pancitopenia por Plasmodium vivax en la Amazonía peruana: reporte de caso

Paredes-Obando

Moreno

Panduro-García

et al. 2022

Rev Peru Med Exp Salud Publica

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Plasmodium vivax es la especie más común en la Amazonía peruana y ocasiona el 81% del total de casos de malaria. Presentamos el caso de un paciente adulto varón con malaria cerebral por Plasmodium vivax, que inicia con malestar general y fiebre, luego presenta convulsiones más de dos veces al día con pérdida de consciencia y limitación funcional motora. Se le realiza gota gruesa donde se observa trofozoítos de Plasmodium vivax y depresión de las tres series sanguíneas. Se inicia tratamiento con artesunato y clindamicina por cinco días, se le transfunde un paquete globular, y continua con primaquina por siete días. El paciente muestra mejoría clínica con secuela neurológica en extremidad inferior izquierda.

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Section: Discussionunclassified

Section: Introductionunclassified

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Malaria cerebral con pancitopenia por Plasmodium vivax en la Amazonía peruana: reporte de caso

Paredes-Obando

Moreno

Panduro-García

et al. 2022

Rev Peru Med Exp Salud Publica

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“…4 Patients presenting with cerebral symptoms such as acute febrile encephalopathy, raised intracranial pressure, intracerebral haemorrhage, hemiparesis, aphasia and seizures following vivax malaria have been reported previously. 5,6…”

Section: Discussionmentioning

confidence: 99%

Neurological involvement associated with Plasmodium vivax malaria from Pakistan

et al. 2017

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Plasmodium vivax is the most common specie causing malaria outside Africa with approximately 13.8 million reported cases worldwide. We report case of P. vivax infection with cerebral involvement. A nine year old boy presented with high grade fever accompanied by projectile vomiting and abnormal behavior later he developed seizures, shock, and unconsciousness. P. vivax monoinfection was diagnosed based on peripheral smears and PCR. After antimalarial therapy, patient made full recovery. Current case highlights increasing trend of cerebral complications caused by P. vivax.

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“…While cerebral malaria is predominantly associated with P. falciparum (7), recent case reports have highlighted instances of cerebral involvement and severe neurological complications in patients infected with other Plasmodium species (12)(13)(14)(15)(16)(17)(18). A high proportion of severe Pk infections has been reported in Southeast Asia (5,19), as well as fatal cases (18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Plasmodium knowlesiinfection is associated with elevated circulating biomarkers of brain injury and endothelial activation

Bertran-Cobo,

Dumont,

Noordin

et al. 2024

Preprint

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Introduction: Malaria remains a major public health concern with substantial morbidity and mortality worldwide. In Malaysia, the emergence of Plasmodium knowlesi has led to a surge in zoonotic malaria cases and deaths in recent years. Signs of cerebral involvement have been observed in a non-comatose, fatal case of severe knowlesi infection, but the potential impact of this malaria species on the brain remains underexplored. To address this gap, we investigated circulating levels of brain injury, inflammation, and vascular biomarkers in a cohort of knowlesi-infected patients and controls. Methods: Archived plasma samples from 19 patients with confirmed symptomatic knowlesi infection and 19 healthy, age-matched controls from Peninsular Malaysia were analysed. A total of 52 plasma biomarkers of brain injury, inflammation, and vascular activation were measured using Luminex and SIMOA assays. Wilcoxon tests were used to examine group differences, and biomarker profiles were explored through hierarchical clustering heatmap analysis. Results: Bonferroni-corrected analyses revealed significantly elevated brain injury biomarker levels in knowlesi-infected patients, including S100B (p<0.0001), Tau (p=0.0007), UCH-L1 (p<0.0001), αSyn (p<0.0001), Park7 (p=0.0006), NRGN (p=0.0022), and TDP-43 (p=0.005). Compared to controls, levels were lower in the infected group for BDNF (p<0.0001), CaBD (p<0.0001), CNTN1 (p<0.0001), NCAM-1 (p<0.0001), GFAP (p=0.0013), and KLK6 (p=0.0126). Hierarchical clustering revealed distinct group profiles for circulating levels of brain injury and vascular activation biomarkers. Conclusions: Our findings highlight for the first time the impact of Plasmodium knowlesi infection on the brain, with distinct alterations in cerebral injury and endothelial activation biomarker profiles compared to healthy controls. Further studies are warranted to investigate the pathophysiology and clinical significance of these altered surrogate markers, through both neuroimaging and long-term neurocognitive assessments.

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Plasmodium vivaxMalaria Presenting with Multifocal Hemorrhagic Brain Infarcts in a School-going Child

Cited by 4 publications

References 12 publications

Malaria cerebral con pancitopenia por Plasmodium vivax en la Amazonía peruana: reporte de caso

Malaria cerebral con pancitopenia por Plasmodium vivax en la Amazonía peruana: reporte de caso

Neurological involvement associated with Plasmodium vivax malaria from Pakistan

Plasmodium knowlesiinfection is associated with elevated circulating biomarkers of brain injury and endothelial activation

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