title: Cerebral malaria in a man with Plasmodium vivax mono-infection: a case report.
abstract: Cerebral malaria (CM) is a diffuse encephalopathy associated with coma and seizures commonly caused by Plasmodium falciparum (P. falciparum) in children with severe malaria. We present a case of a 19-year-old man with CM due to Plasmodium vivax (P. vivax) infection. Cerebrospinal fluid (CSF) was negative for Japanese B encephalitis, enterovirus, herpes simplex 1 and 2, varicella and mumps viruses as determined by real-time polymerase chain reaction (PCR). P. falciparum and P. vivax species were analysed by microscopy, immunochromatography and PCR assays and confirmed mono-infection of P. vivax in the patient's blood, and P. falciparum infection was established to be negative. The patient was discharged after intensive supportive care and antimalarial treatment (intravenous artesunate and oral doxycycline). We conclude that P. vivax infection is associated with CM, a life-threatening complication rarely seen in coastal districts of Karnataka. In endemic areas, the possibility of CM should be considered even with P. vivax infection.
authors.affiliation: Research Scholar, Department of Biotechnology, School of Life Sciences, Manipal University, Manipal, Karnataka, India.
authors.forename: Himanshu
authors.initials: H
authors.lastname: Gupta
authors.affiliation: Senior Resident, Department of Medicine, Dr. TMA Pai Hospital, Udupi, Melaka Manipal Medical College, Manipal University, Manipal, Karnataka India.
authors.forename: Pushwinder
authors.initials: P
authors.lastname: Dhunputh
authors.affiliation: Junior Resident, Department of Medicine, Dr. TMA Pai Hospital, Udupi, Melaka Manipal Medical College, Manipal University, Manipal, Karnataka India.
authors.forename: Ankita N
authors.initials: AN
authors.lastname: Bhatt
authors.affiliation: Professor and Director, Department of Biotechnology, School of Life Sciences, Manipal University, Manipal, Karnataka, India.
authors.forename: Kapaettu
authors.initials: K
authors.lastname: Satyamoorthy
authors.affiliation: Professor and Head, Department of Medicine, Department of Medicine, Dr. TMA Pai Hospital, Udupi, Melaka Manipal Medical College, Manipal University, Manipal, Karnataka India shashikiran.u@manipal.edu.
authors.forename: Shashikiran
authors.initials: S
authors.lastname: Umakanth
mesh_terms: D061605:Administration, Intravenous; D000284:Administration, Oral; D000962:Antimalarials / Q000627:therapeutic use; D037621:Artemisinins / Q000008:administration & dosage; D000077332:Artesunate; D004318:Doxycycline / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016779:Malaria, Cerebral / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D016780:Malaria, Vivax / Q000150:complications* / Q000188:drug therapy / Q000469:parasitology; D008297:Male; D010966:Plasmodium vivax / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods; D012640:Seizures / Q000209:etiology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D000077332:Artesunate; D004318:Doxycycline
keywords: Plasmodium vivax complications; cerebral malaria; polymerase chain reaction (PCR)