Case reports on atypical presentation of Plasmodium falciparum malaria in pediatric patients

Abstract

Variable atypical symptoms are commonly observed in malaria caused by Plasmodium falciparum especially in endemic tropical nations such as India. Nystagmus is observed following involvement of the cerebellum especially during the postrecovery phase. While psychotic features such as severe agitation, hallucination, paranoia may be the early symptoms of falciparum malaria among pediatric patients, urticaria with or without fever can be the initial manifestation of the disease. As the morbidity and mortality of severe malaria are very high in India, these atypical presentations should be considered during diagnosis. We believe our report on atypical cases of falciparum malaria will sensitize doctors and health personnel about rare presentations in children and help in early diagnosis and management to reduce the severity and death toll due to the disease.

Lipopolysaccharide administration for a mouse model of cerebellar ataxia with neuroinflammation

“…For example, neurotoxic inflammatory responses, involving the production of inflammatory molecules by activated microglia and astrocytes, have been observed in patients and in animal models of hereditary CA, especially spinocerebellar ataxia 6,7 . In addition, some studies suggest that inflammatory responses induced by viral infection or toxic exposures (exposure to alcohol, drugs, or environmental toxins) can cause CA because the cerebellum is especially vulnerable to poisoning and intoxication 8,9,18 . These research findings suggest that the upregulation of inflammatory responses in the cerebellum may be an important mechanism in the progression of CAs and that the control of neuroinflammation may be a potential therapeutic target for the management of CAs.…”

“…In particular, many reports have shown a close relationship between cerebellar inflammation and CA 1 , 3 , 5 . The activation of glial cells resulting in the production of pro-inflammatory molecules has been observed in many animal models of CA and is also evident in the cerebellums of patients with CA 6 – 9 . Furthermore, cerebellar inflammation has been shown to induce the loss of Purkinje cells, which results in cerebellar dysfunction 1 , 7 .…”

Therapeutic Effects of Human Mesenchymal Stem Cells in a Mouse Model of Cerebellar Ataxia with Neuroinflammation

“…Additionally, the cortex neurons and Purkinje cells in cerebellum are particularly vulnerable to poisoning [ 41 ]. Therefore, neurotoxic inflammation caused by toxic exposure such as drugs, alcohol, and environmental chemicals can cause CAs [ 11 , 12 , 42 ]. These findings suggest that neuroinflammation in cerebellum is an important risk factor in the progression of CAs and an attractive therapeutic target for the treatment of CAs.…”

“…In addition, many types of CA have been reported to be closely related to cerebellar inflammation [ 1 , 3 , 7 ]. Recent studies demonstrated over-activation of glial cells and production of proinflammatory molecules in the cerebellum of patients with CA and animal models of CA, caused by genetic mutations, viral infections, and toxic exposures [ 8 , 9 , 10 , 11 , 12 ]. Moreover, several studies have indicated that cerebellar inflammation can lead to the loss of Purkinje cells, resulting in cerebellar dysfunction [ 1 , 13 ].…”

Imported Plasmodium vivax malaria complicated by reversible myocarditis

“…The majority of cardiac complications such as pericardial effusion, bundle branch block, cardiomyopathy, and myocarditis have been attributed to P. falciparum infections. [345] Acute myocarditis secondary to P vivax monoinfection is very rare. Very few cases were found after reviewing the literature.…”