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Postmalaria neurological syndrome: a case report
Leonardo Ponce da Motta1, Márcio Araújo da Costa, Marcelo Barreto Gouvea
1Departamento de Doenças Infecciosas e Parasitárias, Hospital Central do Exército, Rio de Janeiro, RJ, Brasil.
Revista Da Sociedade Brasileira De Medicina Tropical
|January 11, 2012
Summary
Post-malaria neurological syndrome (PMNS) can occur after Plasmodium falciparum infection. Methylprednisolone effectively treated PMNS neuropsychiatric symptoms, unlike acyclovir.
Area of Science:
- Neurology
- Infectious Diseases
- Clinical Medicine
Background:
- Post-malaria neurological syndrome (PMNS) is a rare complication following Plasmodium infection.
- Neuropsychiatric symptoms can manifest weeks to months after the acute phase of malaria.
- Differential diagnosis of neurological complications post-malaria is crucial.
Observation:
- A patient with a history of Plasmodium falciparum infection two months prior presented with neurological symptoms.
- Empirical treatment with acyclovir was initiated, suspecting herpetic meningoencephalitis.
- The patient's neuropsychiatric symptoms did not resolve with acyclovir therapy.
Findings:
- Methylprednisolone administration led to significant improvement in the patient's neuropsychiatric symptoms.
- This suggests a potential inflammatory or autoimmune basis for the neurological manifestations in this case.
- Acyclovir was ineffective, ruling out active herpes simplex virus encephalitis as the primary cause.
Implications:
- Corticosteroid therapy may be a viable treatment option for post-malaria neurological syndrome.
- Further research is warranted to elucidate the pathophysiology of PMNS.
- This case highlights the importance of considering PMNS in patients with neurological symptoms after malaria, even with a significant time delay.
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