[Cerebral malaria].
Cerebral malaria (CM) is a life-threatening complication of falciparum malaria and some types of disturbed consciousness problems are major symptoms of CM. Although the pathogenesis of CM is unknown, the sequestration, the binding of red blood cells containing mature stages of the malaria parasite to the endothelium of the cerebral microvasculature, and the disappearance of erythrocytes infected with mature malaria parasite in the peripheral blood stream, are thought to play a key role in its pathogenesis. Falciparum malaria patients with disturbed consciousness should be considered to suffer from CM; however it should also be examined as to whether other disease complications such as meningitis or hypoglycemia are associated with this condition. The brain CT or MRI of CM patients reveal no specific findings. CM is treated with an intravenous infusion of artesunate or an intravenous drip infusion of quinine. The prognosis of CM patients is very poor without rapid and adequate treatment; therefore, CM is an infectious disease warranting emergency treatment. The number of Japanese CM patients is believed to increase in the near future in accordance with the increase in the number of Japanese travelers visiting tropical or subtropical malaria-endemic areas. Therefore, Japanese clinicians should also be aware of CM, in case a falciparum malaria patient with some consciousness disturbance visits the clinic.
Ohnishi
Kenji
K
Department of Infectious Diseases, Tokyo Metropolitan Bokutoh General Hospital, 4-23-15 Kohtohbashi, Sumida-ku, Tokyo 130-8575, Japan.
D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage; D037621:Artemisinins / Q000008:administration & dosage; D000077332:Artesunate; D017583:Hemodiafiltration; D006801:Humans; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D016779:Malaria, Cerebral / Q000175:diagnosis / Q000469:parasitology / Q000503:physiopathology / Q000628:therapy; D010963:Plasmodium falciparum / Q000472:pathogenicity; D010966:Plasmodium vivax / Q000472:pathogenicity; D011803:Quinine / Q000008:administration & dosage; D006435:Renal Dialysis; D014057:Tomography, X-Ray Computed
D000962:Antimalarials; D037621:Artemisinins; D000077332:Artesunate; D011803:Quinine