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Peer-reviewedCC BY-NC 4.0Iranian Journal of Child Neurology

Cerebral Malaria Due to Plasmodium Vivax: An Unexpected Presentation

  • M Hassaan Shah1
  • Muhammad Osama2
  • Farid Ullah3
  • Imran Ullah1
  • Abdul Basit1
  • Iman Hameed2
  • Waheed Ullah1
  • Farhan Shahzad4
4 affiliations
  1. 1Department of Internal Medicine, Khyber Teaching Hospital, Peshawar, Pakistan.
  2. 2Khyber Medical College, Peshawar, Pakistan.
  3. 3Khyber Teaching Hospital, Peshawar, Pakistan.
  4. 4Department of Medicine, Saidu Group of Teaching Hospital, Swat, Pakistan.
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Abstract

Cerebral malaria (CM) is a severe encephalopathy typically caused by Plasmodium falciparum (P. falciparum), presenting with altered consciousness, confusion, psychomotor agitation, and/or seizures. Diagnostic criteria require the laboratory confirmation of P. falciparum infection, alongside the systematic exclusion of alternative etiologies for encephalopathy. However, rare cases implicating Plasmodium vivax (P. vivax) as the causative agent have been reported.

Pakistan is endemic for P. vivax, generally considered a benign cause of malaria, and encephalopathy is almost never encountered in clinical practice. This study presents a rare case of CM in a 16-year-old boy caused solely by P. vivax, confirmed on thick and thin peripheral smears showing rings and trophozoites. The patient was started on intravenous artesunate, to which he responded well, and was discharged on primaquine for radical cure.

This case highlights the need for clinical vigilance, timely intervention, and recognition of P. vivax as a potential cause of CM, particularly in endemic regions.

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Cite

BibTeXRIS
BibTeX
@article{shah2026cerebral,
  title = {{Cerebral Malaria Due to Plasmodium Vivax: An Unexpected Presentation}},
  author = {M Hassaan Shah and Muhammad Osama and Farid Ullah and Imran Ullah and Abdul Basit and Iman Hameed and Waheed Ullah and Farhan Shahzad},
  journal = {Iranian Journal of Child Neurology},
  year = {2026},
  month = sep,
  doi = {10.22037/ijcn.v20i4.46446},
  url = {https://doi.org/10.22037/ijcn.v20i4.46446},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Cerebral Malaria Due to Plasmodium Vivax: An Unexpected Presentation
AU  - M Hassaan Shah
AU  - Muhammad Osama
AU  - Farid Ullah
AU  - Imran Ullah
AU  - Abdul Basit
AU  - Iman Hameed
AU  - Waheed Ullah
AU  - Farhan Shahzad
PY  - 2026
DA  - 2026/09/01
JO  - Iranian Journal of Child Neurology
DO  - 10.22037/ijcn.v20i4.46446
UR  - https://doi.org/10.22037/ijcn.v20i4.46446
AB  - Cerebral malaria (CM) is a severe encephalopathy typically caused by Plasmodium falciparum (P. falciparum), presenting with altered consciousness, confusion, psychomotor agitation, and/or seizures. Diagnostic criteria require the laboratory confirmation of P. falciparum infection, alongside the systematic exclusion of alternative etiologies for encephalopathy. However, rare cases implicating Plasmodium vivax (P. vivax) as the causative agent have been reported.  Pakistan is endemic for P. vivax, generally considered a benign cause of malaria, and encephalopathy is almost never encountered in clinical practice. This study presents a rare case of CM in a 16-year-old boy caused solely by P. vivax, confirmed on thick and thin peripheral smears showing rings and trophozoites. The patient was started on intravenous artesunate, to which he responded well, and was discharged on primaquine for radical cure.  This case highlights the need for clinical vigilance, timely intervention, and recognition of P. vivax as a potential cause of CM, particularly in endemic regions.
SN  - 1735-4668
SN  - 2008-0700
ER  -