A Case of Plasmodium vivax Malaria with Cerebral Complicatio

Moonsuk Kim; Gayeon Kim; Yumin Kang; Nak-Hyun Kim; Jae Hyun Jeon; Wan Beom Park; Hong Bin Kim; Nam Joong Kim; Sang-Won Park; Yoon-Ho Hong; Myoung-don Oh

doi:10.3947/ic.2009.41.5.309

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Kim, Kim, Kang, Kim, Jeon, Park, Kim, Kim, Park, Hong, and Oh: A Case of Plasmodium vivax Malaria with Cerebral Complicatio

Case Report

Infection and Chemotherapy

Infection and Chemotherapy 2009; 41(5): 309-313.

Published online: 31 October 2009

DOI: https://doi.org/10.3947/ic.2009.41.5.309

A Case of Plasmodium vivax Malaria with Cerebral Complicatio

Moonsuk Kim, M.D.¹, Gayeon Kim, M.D.¹, Yumin Kang, M.D., Nak-Hyun Kim, M.D.¹, Jae Hyun Jeon, M.D.¹, Wan Beom Park, M.D.¹, Hong Bin Kim, M.D.¹, Nam Joong Kim, M.D.¹, Sang-Won Park, M.D.¹, Yoon-Ho Hong, M.D.², Myoung-don Oh, M.D.¹

¹Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

²Department of Neurology, Boramae Medical Center, Seoul, Korea.

Correspondence author: Sang-Won Park, M.D. Department of Internal Medicine, Boramae Medical Center, 31-1 Boramae-Gil, Dongjak-Gu, Seoul, 156-707, Korea. Tel: +82-2-870-2224, Fax: +82-2-870-3863, hswon1@snu.ac.kr

Received 11 August 2009 Accepted 18 September 2009

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Plasmodium vivax malaria is an endemic disease in Korea, which rarely causes severe complications including those occurring in the cerebrum. There are limited numbers of complicated cases that have been reported around the world. We experienced a case of vivax malaria with cerebral complication: cognitive impairment and ataxia. A 55-year-old female with diabetes mellitus presented to the emergency department with acute fever of two days' duration. She did not have any history of travelling abroad or receiving blood transfusions. Peripheral blood smear revealed vivax malaria with parasitemia density of 0.53 percent. She demonstrated loss of orientation, especially regarding time and place, and ataxia. Although the initial hydroxychloroquine treatment for malaria was successful, cognitive impairment and ataxia persisted and were not recovered. Brain MRI showed no structural abnormality. Brain PET showed diffuse hypometabolism in right parieto-temporal lobe of the brain.

Keywords: Plasmodium vivax, Cerebral malaria, Korea

Figures and Tables

Figure 1

The patient's brain PET imaging revealed that glucose metabolism decreased diffusely in right temporal and parietal lobe.

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