Cerebral Malaria Insights: Pathogenesis, Host Parasite Interactions including Host Resistance

The in depth clinical analysis of cerebral malaria includes a case study (hypothetical in this particular condition). We analyze the clinical conditions in different stages of Plasmodium falciparum infection in susceptible individual: A 3-year-old African-American boy was brought to the emergency department by his mother in a small town in Ethiopia. The child complained of a persistent headache for a few days. He eventually developed coughing, lethargy, generalized joint pain, nausea, vomiting and a high fever which came and went with shaking chills. The physician examined the patient, and he noted splenomegaly under left costal margin and upper left quadrant along with bilateral retinal hemorrhages on funduscopic exam. The patient was immediately admitted to the pediatric floor as the physician suspected malaria, a common disease in the local area. Blood work was drawn to measure the boy’s CBC, electrolytes, urea, creatinine, haptoglobin, lactic dehydrogenase and reticulocyte count. A lumbar puncture was done along with blood, urine, and sputum cultures plus a test for HIV. Dipstick tests for P falciparum histidine-rich protein-2 (PfHRP-2) antigen were positive. Following admission to the floor, the patient suffered a tonic clonic seizure which developed into status epilepticus. The boy was sedated and ventilated. He had a Blantyre coma score of 1, and he died hours later from septic shock.