Related Experiment Video
Updated: May 7, 2026
09:04
In Vivo Tracking of Edema Development and Microvascular Pathology in a Model of Experimental Cerebral Malaria Using Magnetic Resonance Imaging
Published on: June 8, 2017
Pulmonary pathology in pediatric cerebral malaria
Danny Milner1, Rachel Factor, Rich Whitten
1Anatomic & Clinical Pathology, The Brigham & Women's Hospital, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA; The Blantyre Malaria Project, University of Malawi College of Medicine, 32256, Chichiri, Blantyre 3, Malawi.
Human Pathology
|October 1, 2013
Summary
Fatal malaria in African children causes respiratory distress not from lung damage, but linked to increased malaria pigment (hemozoin) in cerebral malaria cases. Autopsy findings reveal parasite presence and comorbidities.
Area of Science:
- Pathology
- Tropical Medicine
- Pediatrics
Background:
- Respiratory signs are frequent in African children in malaria-endemic regions, complicating the assessment of pulmonary pathology.
- Plasmodium falciparum malaria is a leading cause of death in many African children, often presenting with respiratory symptoms.
Purpose of the Study:
- To describe the pathological manifestations of fatal malaria in children.
- To elucidate the roles of malaria parasites, pigment (hemozoin), and macrophages in fatal malaria.
- To identify and catalog comorbidities associated with fatal malaria.
Main Methods:
- Examination of lung tissue from 100 children in an autopsy series from Blantyre, Malawi.
- Inclusion of 55 patients with cerebral malaria and 45 controls (noncerebral malaria and nonmalarial diagnoses).
- Morphological evaluation and immunohistochemistry on four cores of lung tissue per patient.
Main Results:
- Large numbers of Plasmodium falciparum parasites and malaria pigment (hemozoin) were observed in pulmonary alveolar capillaries of cerebral malaria patients.
- Pulmonary macrophage counts did not significantly differ between cerebral malaria, noncerebral malaria, and nonmalarial groups.
- Comorbidities in cerebral malaria patients included pneumonia, pulmonary edema, hemorrhage, and systemic coagulation activation.
Conclusions:
- Respiratory distress in cerebral malaria appears unrelated to anatomical lung pathology.
- Increased malaria pigment (hemozoin) deposition in the lungs is strongly associated with fatal cerebral malaria at autopsy.
More Related Videos
Related Concept Videos
01:22Bacterial Meningitis I: Introduction
Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
01:26Bacterial Meningitis II: Pathophysiology
Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
01:18Viral Meningitis
Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
01:26Brain Abscess l: Introduction
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
01:19Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...