Ophthalmologic identification of cerebral malaria in adults.
OBJECTIVE
To report the clinical presentation of malarial retinopathy in an adult, emphasizing the importance of this diagnosis for the clinical suspicion and prognosis of cerebral malaria.


METHODS
A 39-year-old caucasian man presented with hemolytic anemia, thrombocytopenia, acidemia and acute renal failure, developing severe encephalopathy. The diagnosis of Plasmodium falciparum malaria was done and after systemic stabilization, the patient noticed a central scotoma in the left eye. Ophthalmological examination revealed retinal features of malarial retinopathy.


RESULTS
At one-month follow-up, the patient had improved his systemic condition and the left eye scotoma had disappeared. Visual acuity was 20/20 in both eyes and on examination almost all lesions had regressed.


CONCLUSIONS
Malarial retinopathy is a diagnostic factor and a prognosis indicator of severe P. falciparum infection, usually with brain involvement. The knowledge of the ophthalmological features associated with severe malaria, which is more frequent in children but can also occur in adults, becomes imperative in order to reduce the risk of neurologic sequelae and associated mortality.
Ophthalmology Department, Hospital Prof. Doutor Fernando Fonseca E.P.E., Amadora, Portugal.
Catarina Areias
CA
Pedrosa
Ophthalmology Department, Hospital Prof. Doutor Fernando Fonseca E.P.E., Amadora, Portugal.
Cristina
C
Santos
Ophthalmology Department, Hospital Prof. Doutor Fernando Fonseca E.P.E., Amadora, Portugal.
Inês
I
Coutinho
Ophthalmology Department, Hospital Prof. Doutor Fernando Fonseca E.P.E., Amadora, Portugal.
Maria
M
Lisboa
Ophthalmology Department, Hospital Prof. Doutor Fernando Fonseca E.P.E., Amadora, Portugal.
Susana
S
Teixeira
Ophthalmology Department, Hospital Prof. Doutor Fernando Fonseca E.P.E., Amadora, Portugal.
Filomena
F
Silva
Ophthalmology Department, Hospital Prof. Doutor Fernando Fonseca E.P.E., Amadora, Portugal.
Graça
G
Pires
Ophthalmology Department, Hospital Prof. Doutor Fernando Fonseca E.P.E., Amadora, Portugal.
Isabel
I
Prieto
encephalopathy; malaria; malarial retinopathy