[Negative serologic and microscopic studies in vivo do not exclude malaria. Autopsy report with positive Plasmodium falciparum culture].
A 31-year old man, who had just flown in from the tropics collapsed certainly. Brain trauma and alcohol withdrawal were excluded. After serological and microscopical malaria tests had been negative, subarachnoidal bleeding or encephalomeningitis were considered as possible. Although repeated malaria tests were negative, antimalarial therapy was begun on the 8th day of illness. The patient died the next day on respiratory difficulties. Cultures from blood and spleen taken three days after death showed malaria rings, and also trophozoites were found in the spleen and the bone marrow etc. The brain contained schizonts. Malaria infection from older corpses is possible. Negative malaria test results should not delay malaria treatment or exclude malaria diagnosis. Plasmodium culture should be taken whenever malaria is suggested. The possibility of malaria should always be considered. To decide in dubio pro reo in doubtful cases, particularly in forensic medicine.
D000328:Adult; D001853:Bone Marrow / Q000473:pathology; D001921:Brain / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D007668:Kidney / Q000473:pathology; D008168:Lung / Q000473:pathology; D008288:Malaria / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D010963:Plasmodium falciparum / Q000254:growth & development; D013154:Spleen / Q000473:pathology
Negative serologische und mikroskopische Untersuchungen in vivo schliessen eine Malaria noch nicht aus. Obduktionsbericht mit positiver Plasmodium falciparum-Kultur.