European Journal of Biomedical and Pharmaceutical Sciences

CEREBRAL MALARIA IN AN EMERGENCY PAEDIATRICS UNIT OF A DEVELOPING COUNTRY - A CASE REPORT WITH A REVIEW OF THE LITERATURE

*Shogo A.O., Ojo B.A., Abdallah R.J., Dabit J.O., Ogbu O., Ajeh A.O., Bandin S.K., Ikuren I. and Ijiko B.E.

ABSTRACT

Malaria continues to be an important global health issue with significant prevalence in Sub-Saharan Africa. Cerebral Malaria is a severe manifestation of Plasmodium falciparum infection. Cerebral malaria is defined as the presence of coma in a child with P. falciparum parasitaemia and an absence of other reasons for coma. It carries with it significant mortality as well as debilitating sequelae for its survivors such as sensorineural deafness and cortical blindness. We present below a 14year old girl who presented with 6days of high-grade fever, headache, vomiting, multiple convulsions and subsequent loss of consciousness. Examination findings showed that she had features of raised intracranial pressure at admission. Investigation results revealed asexual forms of Plasmodium falciparum in the peripheral blood film and absence of evidence of a concomitant infection. She was managed as a case of Cerebral Malaria and was treated with intravenous Artesunate, Mannitol, Diazepam and Phenobarbitone. She however succumbed to the illness within 6hours of admission. Autopsy findings were significant for a slaty grey enlarged spleen as well as an enlarged and oedematous brain with pinpoint hemorrhages. This report is aimed at re-emphasizing the significant fatality rate of cerebral malaria, as well as, to remind clinicians working in malaria-endemic regions about the need for early diagnosis and prompt treatment.

Keywords: Cerebral malaria, convulsions, coma, Plasmodium falciparum, Benue, Nigeria.