PMC5173515_01
Blood smears. Each sample was taken one day before admission (A), on hospital day 1 (B), day 3 (C) and day 7 (D) respectively. The ratios of paracitemia are 30% (A), 16% (B), 0.3% (C) and 0% (D) respectively.
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To confirm a malaria diagnosis, photographs of the blood smear were sent to our hospital laboratory (Fig. 1A), and approximately 30% of the patient's red blood cells were found to be infected with P. falciparum. A peripheral blood smear using Giemsa stain revealed the presence of P. falciparum with a parasitemia level of 16% (Fig. 1B). As a result of these treatments, the parasitemia was reduced to 2% by Day 2 following admission (Fig. 1C), and no infected blood cells were detected on Day 7 (Fig. 1D).
Time course of MRI. Fluid-attenuation inversion recovery (FLAIR) images showed diffusely increased signal intensity in cerebral white matter on hospital day 7 (A) and this changes was improving gradually, on day 20 (B), day 36 (C) and day 48 (D).
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T2-weighted and fluid-attenuation inversion recovery (FLAIR) images showed that brain swelling was slightly improved, but the signal intensity was increased in the patient's cerebral white matter (Fig. 2A). Follow-up MRI and EEG on Day 20 confirmed that the leukoencephalopathy was improving (Fig. 2B), although an EEG showed that the slow waves remained; however, the theta waves in the frontal lobe were absent (Fig. 3B).
Time course of electroencephalography (EEG: mono polar 1). EEG on hospital day 7 (A) revealed generally slow waves with theta waves in the frontal lobe (open circle) (channel 5 was not recorded due to recorder trouble). Theta waves in the frontal lobe disappeared on day 20 (B) and background frequency recovered on day 58 (C).
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EEG revealed slow-wave activity in general, along with theta waves in the frontal lobe (Fig. 3A).