Abstract
Several neurological complications are associated with severe falciparum malaria. Indeed, some patients experience a neurological syndrome after complete recovery from Plasmodium falciparum infection. Particularly, postmalaria neurological syndrome (PMNS) is a self-limiting post-infective encephalopathy that occurs within 2 months after an episode of P. falciparum infection. We describe the case of a 54-year-old Japanese man who was readmitted to our hospital with incoherent speech and markedly disturbed and uncooperative behavior after a high-grade fever that occurred after an earlier adequately treated severe P. falciparum infection. Peripheral blood smears were repeatedly negative for malaria parasites, no organisms were detected in the cerebrospinal fluid, and no hallmark lesions of acute disseminated encephalomyelitis were depicted by brain magnetic resonance imaging. The neuropsychiatric symptoms were thought to be due to PMNS. The etiology of PMNS remains unclear, but it could be mediated by an immunological mechanism and could possibly be caused by mefloquine treatment. PMNS must be considered when characteristic neurological signs and symptoms such as psychotic or acute confusional episodes, general convulsions, and tremor occur after recovery from severe P. falciparum infection treated with oral mefloquine. This is the first reported case of suspected PMNS in Japan.
Similar content being viewed by others
References
TH Nguyen NP Day VC Ly D Waller HP Nguyen DB Bethell et al. (1996) ArticleTitlePost-malaria neurological syndrome Lancet 348 917–21 Occurrence Handle8843810 Occurrence Handle10.1016/S0140-6736(96)01409-2 Occurrence Handle1:STN:280:DyaK2s%2FgtVOmtg%3D%3D
SD Lawn KL Flanagan SG Wright TF Doherty P Godfrey-Faussett (2003) ArticleTitlePostmalaria neurological syndrome: two cases from the Gambia Clin Infect Dis 36 e29–31 Occurrence Handle12522765 Occurrence Handle10.1086/344774
GS Falchook CM Malone S Upton WX Shandera (2003) ArticleTitlePostmalaria neurological syndrome after treatment of Plasmodium falciparum malaria in the United States Clin Infect Dis 37 e22–4 Occurrence Handle12856230 Occurrence Handle10.1086/375269
AH Mohsen MW McKendrick ML Schmid ST Green M Hadjivassiliou C Romanowski (2000) ArticleTitlePostmalaria neurological syndrome: a case of acute disseminated encephalomyelitis? J Neurol Neurosurg Psychiatry 68 388–9 Occurrence Handle10787306 Occurrence Handle10.1136/jnnp.68.3.388a Occurrence Handle1:STN:280:DC%2BD3c3jvV2lsA%3D%3D
AB Dey I Trikha M Banerjee R Jain KM Nagarkar (2001) ArticleTitleAcute disseminated encephalomyelitis. Another cause of post malaria cerebellar ataxia J Assoc Physicians India 49 756–8 Occurrence Handle11573566 Occurrence Handle1:STN:280:DC%2BD3MrislGktQ%3D%3D
N Senanayake (1987) ArticleTitleDelayed cerebellar ataxia: a new complication of falciparum malaria? Br Med J (Clin Res Ed) 294 1253–4 Occurrence Handle1:STN:280:DyaL2s3ktlejtg%3D%3D Occurrence Handle10.1136/bmj.294.6582.1253
N Senanayake HJ de Silva (1994) ArticleTitleDelayed cerebellar ataxia complicating falciparum malaria: a clinical study of 74 patients J Neurol 241 456–9 Occurrence Handle7931448 Occurrence Handle10.1007/BF00900965 Occurrence Handle1:STN:280:DyaK2M%2Fhs1ynsw%3D%3D
T Weinke M Trautmann T Held G Weber D Eichenlaub K Fleischer et al. (1991) ArticleTitleNeuropsychiatric side effects after use of mefloquine Am J Trop Med Hyg 45 86–91 Occurrence Handle1867351 Occurrence Handle1:STN:280:DyaK3MzivVentg%3D%3D
G van der Wal WI Verhagen AS Dofferhoff (2005) ArticleTitleNeurological complications following Plasmodium falciparum infection Neth J Med 63 180–3 Occurrence Handle15952488 Occurrence Handle1:STN:280:DC%2BD2MzgsFeitg%3D%3D
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Mizuno, Y., Kato, Y., Kanagawa, S. et al. A case of postmalaria neurological syndrome in Japan. J Infect Chemother 12, 399–401 (2006). https://doi.org/10.1007/s10156-006-0489-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10156-006-0489-0