Smear-Negative Cerebral Malaria Due to Mefloquine-Resistant Plasmodium falciparum Acquired in the Amazon

All accepted case definitions of cerebral malaria require the presence of P. falciparum parasitemia. Smear-negative cerebral malaria has been reported, but it is extremely rare and has been accompanied by the finding of P. falciparum parasites in the cerebral vasculature at autopsy. Smear-negative c...

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Bibliographic Details
Published in:The Journal of infectious diseases 1992-12, Vol.166 (6), p.1458-1459
Main Authors: Zucker, Jane R., Campbell, Carlos C.
Format: Article
Language:English
Subjects:
Animals
Blood
Cerebral malaria
Correspondence
Diseases
Drug Resistance
Humans
Malaria
Malaria, Cerebral - parasitology
Mefloquine - pharmacology
Parasitemia
Parasites
Plasmodium falciparum
Plasmodium falciparum - drug effects
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Summary:All accepted case definitions of cerebral malaria require the presence of P. falciparum parasitemia. Smear-negative cerebral malaria has been reported, but it is extremely rare and has been accompanied by the finding of P. falciparum parasites in the cerebral vasculature at autopsy. Smear-negative cerebral malaria may occur in a synchronously replicating P. falciparum infection, with parasites completely sequestered in capillary beds at the time of the blood film examination. However, after rupture of the sequestered schizonts into the bloodstream, young trophozoites circulate freely in erythrocytes, and blood smears repeated at 6- to 12-h intervals will invariably reveal parasites. Parasites were never demonstrated after initial treatment in the case reported by Chia et al.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/166.6.1458-b