Brain magnetic resonance imaging in imported malaria

Abstract Background Previous studies have documented a spectrum of brain magnetic resonance imaging (MRI) abnormalities in patients with cerebral malaria, but little is known about the prevalence of such abnormalities in patients with non-cerebral malaria. The aim of this study was to assess the fre...

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Bibliographic Details
Published in:Malaria Journal
Main Authors: Andreas M. Frölich, Pinkus Tober-Lau, Michael Schönfeld, Thomas T. Brehm, Florian Kurth, Christof D. Vinnemeier, Marylyn M. Addo, Jens Fiehler, Thierry Rolling
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2019
Subjects:
Malaria
Imported malaria
Cerebral malaria
MRI
P. falciparum
Complicated malaria
Arctic medicine. Tropical medicine
RC955-962
Infectious and parasitic diseases
RC109-216
Arctic
Online Access:https://doi.org/10.1186/s12936-019-2713-2
https://doaj.org/article/c1206d75f1d74dd08b28f6a2b496a799
Description
Summary:Abstract Background Previous studies have documented a spectrum of brain magnetic resonance imaging (MRI) abnormalities in patients with cerebral malaria, but little is known about the prevalence of such abnormalities in patients with non-cerebral malaria. The aim of this study was to assess the frequency of brain MRI findings in returning travellers with non-cerebral malaria. Methods A total of 17 inpatients with microscopically confirmed Plasmodium falciparum non-cerebral malaria underwent structural brain MRI at 3.0 Tesla, including susceptibility-weighted imaging (SWI). Presence of imaging findings was recorded and correlated with clinical findings and parasitaemia. Results Structural brain abnormalities included a hyperintense lesion of the splenium on T2-weighted imaging (n = 3) accompanied by visible diffusion restriction (n = 2). Isolated brain microhaemorrhage was detected in 3 patients. T2-hyperintense signal abnormalities of the white matter ranged from absent to diffuse (n = 10 had 0–5 lesions, n = 5 had 5–20 lesions and 2 patients had more than 50 lesions). Imaging findings were not associated with parasitaemia or HRP2 levels. Conclusion Brain MRI reveals a considerable frequency of T2-hyperintense splenial lesions in returning travellers with non-cerebral malaria, which appears to be independent of parasitaemia.

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