title: Steroid Pulse Therapy May Mitigate Prolonged Neurological Manifestations after Eradication of Severe Plasmodium falciparum Parasitemia.
abstract: A 58-year-old Japanese man with a high parasitemia of Plasmodium falciparum, returning from Uganda, was admitted to our hospital since his consciousness level rapidly deteriorated after the initial dose of mefloquine. Despite the parasitemia was cleared by quinine by day 7, the coma remained unchanged and diffuse leukoencephalopathy was detected on magnetic resonance image. Steroid pulse therapy was initiated on day 8. Subsequently, the neurological manifestations improved and he was discharged on day 73 without any sequelae. Pathogenesis of P. falciparum causing cerebral malaria is diverse and complex. If neurological symptoms unusually prolong, steroid may be an effective treatment option.
authors.affiliation: Department of Infectious Disease, Nagoya City East Medical Center, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Hasegawa
authors.forename: Akiko
authors.initials: A
authors.lastname: Inagaki
authors.forename: Gohei
authors.initials: G
authors.lastname: Yamada
authors.forename: Koji
authors.initials: K
authors.lastname: Morita
authors.forename: Isamu
authors.initials: I
authors.lastname: Kitamura
authors.forename: Koya
authors.initials: K
authors.lastname: Ariyoshi
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use*; D003128:Coma / Q000209:etiology; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D016779:Malaria, Cerebral / Q000188:drug therapy*; D016778:Malaria, Falciparum / Q000150:complications / Q000188:drug therapy*; D008297:Male; D015767:Mefloquine / Q000627:therapeutic use; D008875:Middle Aged; D018512:Parasitemia / Q000188:drug therapy*; D010963:Plasmodium falciparum; D020551:Pulse Therapy, Drug; D011803:Quinine / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000962:Antimalarials; D005938:Glucocorticoids; D011803:Quinine; D015767:Mefloquine