Pediatric Psychosis in the Emergency Room : Could it be Plasmodium Vivax Malaria?

Authors(3) :-Ekram T, Afzal K, Saxena R

Malaria is associated with severe neurological complication especially by Plasmodium falciparum. We report a case of acute malaria in a seven year old boy presenting with features of psychosis as the primary presenting complaint, with absence of fever or concomitant drug intake before arrival. Peripheral blood smear of patient subsequently revealed Plasmodium vivax (ring and trophozoite stage) as he was investigated further when febrile spikes appeared.

Malaria is associated with severe neurological complications especially by P. falciparum. We report a case of acute malaria in a seven year old boy presenting with features of psychosis as the initial presenting complaint, without history of fever or concomitant drug intake before arrival. Peripheral blood smear revealed P. vivax (ring and trophozoite stage).

Authors and Affiliations

Ekram T
Department of Pediatrics and Neonatology, Max Healthcare, Greater Noida, Uttar Pradesh, India
Afzal K
Department of Pediatrics, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
Saxena R
Pediatric intensive care unit, Medanta-The Medicity, Gurgaon, Haryana, India

Psychosis, Plasmodium Vivax, Malaria

  1. World Health Organization. Malaria. [Cited 2016 Mar 3]. Available from: http://www.who.int/gho/malaria/en/
  2. Schmutzhard E, Gerstenbrand F. Cerebral malaria in Tanzania. Its epidemiology, clinical symptoms and neurological long term sequelae in the light of 66 cases. Trans R Soc Trop Med Hyg. 1984; 78(3):351–3.
  3. Bondi FS. The incidence and outcome of neurological abnormalities in childhood cerebral malaria: a long-term follow-up of 62 survivors. Trans R Soc Trop Med Hyg. 1992; 86(1):17–9.
  4. Sowunmi A. Psychosis after cerebral malaria in children. J Natl Med Assoc. 1993; 85(9):695–6.
  5. Brewster DR, Kwiatkowski D, White NJ. Neurological sequelae of cerebral malaria in children. Lancet Lond Engl. 1990; 336(8722):1039–43.
  6. Sowunmi A, Ohaeri JU, Falade CO. Falciparum malaria presenting as psychosis. Trop Geogr Med. 1995; 47(5): 218–9.
  7. Courvoisier H, Labellarte MJ, Riddle MA. Psychosis in children: diagnosis and treatment. Dialogues Clin Neurosci. 2001; 3(2):79–92.
  8. Lebain P, Juliard C, Davy JP, Dollfus S. [Neuropsychiatric symptoms in preventive antimalarial treatment with mefloquine: apropos of 2 cases]. L’Encéphale. 2000; 26(4):67–70.
  9. Folkerts H, Kuhs H. [Psychotic episode caused by prevention of malaria with mefloquine. A case report]. Nervenarzt. 1992; 63(5):300–2.
  10. Meier CR, Wilcock K, Jick SS. The risk of severe depression, psychosis or panic attacks with prophylactic antimalarials. Drug Saf. 2004; 27(3): 203–13.
  11. Gupte S. Occurrence of chloroquine-induced psychotic manifestations in children with malaria. Ann Trop Paediatr. 1992; 12(2): 229.
  12. Bhatia MS, Singhal PK, Dhar NK. Chloroquine induced psychosis. Indian Pediatr. 1988; 25(3):258–62.
  13. Kabir SM. Chloroquine psychosis. Trans R Soc Trop Med Hyg. 1969; 63(4):549.
  14. Garg RK, Karak B, Misra S. Neurological manifestations of malaria: an update. Neurol India. 1999; 47(2):85–91.
  15. Kochar DK, Shubhakaran null, Kumawat BL, Kochar SK, Halwai M, Makkar RK, et al. Cerebral malaria in Indian adults: a prospective study of 441 patients from Bikaner, north-west India. J Assoc Physicians India. 2002; 50:234–41.
  16. Hsieh C-F, Shih  P-Y, Lin  R-T.  Postmalaria  neurologic  syndrome:  a  case  Kaohsiung J Med Sci. 2006; 22(12):630–5.
  17. Tilluckdharry CC, Chadee DD, Doon R, Nehall J. A case of vivax malaria presenting with psychosis. West Indian Med J. 1996; 45(1):39–40.
  18. Wintrob   Malaria and the acute psychotic episode.  J  Nerv Ment Dis.  1973; 156(5):306–17.
  19. Oberfield RA, Burkes L, Feinberg SS. Cerebral malaria: a diagnostic dilemma. A case report. Gen Hosp Psychiatry. 1981; 3(3):227–9.
  20. Prakash MV, Stein G. Malaria presenting as atypical depression. Br J Psychiatry J Ment Sci. 1990; 156:594–5.
  21. Yelamali BC, Talawar M, Pol R. Psychosis in a Child Infected with Vivax Malaria: A Case Report. 2011 [cited 2016, Mar 3]; Available from: http://www.jcdr.net

Publication Details

Published in : Volume 2 | Issue 6 | November-December 2016
Date of Publication : 2016-12-31
License:  This work is licensed under a Creative Commons Attribution 4.0 International License.
Page(s) : 468-470
Manuscript Number : IJSRST162412
Publisher : Technoscience Academy

Print ISSN : 2395-6011, Online ISSN : 2395-602X

Cite This Article :

Ekram T, Afzal K, Saxena R, " Pediatric Psychosis in the Emergency Room : Could it be Plasmodium Vivax Malaria? ", International Journal of Scientific Research in Science and Technology(IJSRST), Print ISSN : 2395-6011, Online ISSN : 2395-602X, Volume 2, Issue 6 , pp.468-470, November-December-2016.
Journal URL : https://ijsrst.com/IJSRST162412
Citation Detection and Elimination     |      | | BibTeX | RIS | CSV

Article Preview