Abstract Ref Number = APCP954
CEREBRAL MALARIA IN CHILDREN ON ENDEMIC AREA- A CASE REPORT
Amaliah Harumi Karim,Angga Maulana Ibrahim
Weeluri Primary Health Care Waibakul General Hospital
Background : Malaria is a transmitted disease caused by Plasmodium. East Nusa Tenggara is one of its endemic area. Untreated malaria could progress into severe malaria with cerebral malaria as one of the important manifestations. On children, this case could lead into high number of morbidity and mortality.
Case Presentation Summary : An 8 years old boy referred to emergency room of Central Sumba regional hospital with chief complaint deteriorating of consciousness since 12 hours before admission. The patient complained fever, headache, stomach pain, nausea and vomiting since a week ago. Physical examination revealed that patient is stupor, hyperpyrexia, tachycardia, and splenomegaly was found on abdominal examination, while meningeal signs and lateralization are absent. Laboratory tests revealed anemia and thrombocytopenia. Microscopic test revealed mixed infection of P. falciparum and P. malariae. Artesunat and cefotaxime injection was given to the patient and switched to antimalaria oral once patient’s consciousness improved, packed red cell transfusion was also given. The diagnosis of cerebral on this patient was based on his deteriorating consciousness preceded by fever since a week ago. Physical examination found the patient stupor, fever, splenomegaly with no meningeal signs. Laboratory tests revealed anemia and thrombocytopenia, microscopic test revealed mixed infection. On cerebral malaria case, artesunate injection should be given until patient’s consciousness improved. Cefotaxime injection was given to the patient since bacterial meningitis couldn’t be ruled out. Transfusion was indicated as patient’s hemoglobin score was under 7 g/dl. Post therapy microscopic test resulted in negative malaria, nevertheless, further evaluation wasn’t performed.
Learning Points/Discussion : Early symptoms of malaria aren’t specific render it difficult to distinguish it from other infection disease, especially in endemic area. On children, it caused high morbidity and mortality rate. Rapid diagnosis and treatment of it resulted in better prognosis.
Keywords: Cerebral Malaria Children Diagnosis