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Ben Abderrahim S, Gharsallaoui S, Ben Daly A, Mosbahi A, Chaieb S, Nfikha Z, Ismaïl S, Makni C, Mokni M, Fathallah-Mili A, Jedidi M, Ben Dhiab M. Imported malaria in adults: about a case of cerebral malaria. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2022; 12:19. [PMID: 35382261 PMCID: PMC8972756 DOI: 10.1186/s41935-022-00279-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/27/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Malaria is the first parasitic infection endemic in the world caused by parasites species of Plasmodium. Cerebral malaria (CM) is a rapidly progressive and severe form of Plasmodium falciparum infection, characterized by a greater accumulation of red blood cells parasitized by Plasmodium falciparum in the brain. The diagnosis of malaria is usually made in living patients from a blood sample taken in the course of a fever on return from an endemic country, whereas CM, often associated with fatal outcomes even in treated subjects, is usually diagnosed at autopsy.
Case presentation
We present the case of a 36-year-old man who died a few days after returning from a business trip to the Ivory Coast. As a result of an unclear cause of death, a medicolegal autopsy was ordered. Autopsy findings revealed massive congestion and edema of the brain with no other macroscopic abnormalities at organ gross examination. Histology and laboratory tests were conducted revealing a Plasmodium falciparum infection, with numerous parasitized erythrocytes containing dots of hemozoin pigment (malaria pigment) in all examined brain sections and all other organs. Death was attributed to cerebral malaria with multiple organ failure.
Conclusions
This report summarizes several features for the diagnosis of malaria and how postmortem investigations, as well as histology and laboratory diagnosis, may lead to a retrospective diagnosis of a fatal complicated form with cerebral involvement.
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Sevestre J, Bernardi C, Gillet M, Delaunay P, Fanjat Y, Toni G, Marty P, Alunni V, Pomares C. Post-mortem diagnosis of imported malaria in France: a case report. Malar J 2021; 20:271. [PMID: 34126991 PMCID: PMC8201817 DOI: 10.1186/s12936-021-03806-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/07/2021] [Indexed: 11/25/2022] Open
Abstract
Background Malaria is a potentially lethal parasitic disease due to infection by Plasmodium parasites, transmitted by Anopheles mosquito vectors. Various preventative measures may be recommended for travellers who visit endemic areas. The diagnosis is generally evoked in the context of a febrile patient returning from an endemic zone. Nevertheless, symptoms and clinical signs may be difficult to interpret, and fatal cases may only be diagnosed retrospectively with laboratory techniques, specific pathological features and patient history. The present work reports a case of fatal cerebral malaria diagnosed post-mortem, along with the techniques that allowed identification of the causative agent. Case presentation A 29 year-old male was found dead in his rental home during a vacation in Southern France. In the absence of explainable cause, an autopsy was performed, which did not retrieve major lesions. In the context of frequent business-related travels in tropical Africa, several samples were adressed for parasitological examination. Microscopy techniques, along with immunochromatographic and molecular biology assays, led to post-mortem diagnosis of fatal cerebral malaria. It was discovered in retrospect that the patient had not used preventative measures against malaria when travelling in endemic zones, and had not been provided with proper travel medicine counseling prior to his travel. Conclusion A vast proportion of imported malaria cases reported in France concerns patients who did not use preventive measures, such as bed nets, repellents or chemoprophylaxis. Given the wide availability of prevention tools in developed countries, and the important number of declared imported malaria cases, there is no doubt traveller awareness still needs to be raised. Moreover, healthcare professionals should always question travel history in febrile patients. The authors advocate for recurrent information campaigns for travellers, and physician training for a better prevention and diagnosis of malaria cases.
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Affiliation(s)
- Jacques Sevestre
- Service de Parasitologie-Mycologie, Hôpital L'Archet, Centre Hospitalier Universitaire de Nice, UCA, 151 route de Saint Antoine de Giestière, 06000, Nice, France.
| | - Caroline Bernardi
- Laboratoire de Médecine Légale Et Anthropologie Médico-Légale, Hôpital Cimiez, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Morgane Gillet
- Laboratoire de Médecine Légale Et Anthropologie Médico-Légale, Hôpital Cimiez, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Pascal Delaunay
- Service de Parasitologie-Mycologie, Hôpital L'Archet, Centre Hospitalier Universitaire de Nice, UCA, 151 route de Saint Antoine de Giestière, 06000, Nice, France
| | - Youta Fanjat
- Laboratoire Central D'Anatomie Pathologique, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Giorgio Toni
- Laboratoire Central D'Anatomie Pathologique, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Pierre Marty
- Service de Parasitologie-Mycologie, Hôpital L'Archet, Centre Hospitalier Universitaire de Nice, UCA, 151 route de Saint Antoine de Giestière, 06000, Nice, France
| | - Véronique Alunni
- Laboratoire de Médecine Légale Et Anthropologie Médico-Légale, Hôpital Cimiez, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Christelle Pomares
- Service de Parasitologie-Mycologie, Hôpital L'Archet, Centre Hospitalier Universitaire de Nice, UCA, 151 route de Saint Antoine de Giestière, 06000, Nice, France.,Equipe 6 Virulence Microbienne Et Signalisation Inflammatoire, C3M, INSERM 1065, Nice, France
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Desoubeaux G, Simon EG, Perrotin D, Chandenier J. The Mobile Team of Parasitology-Mycology, a medical entity for educational purposes to serve sick patients. J Mycol Med 2013; 24:144-51. [PMID: 24316319 DOI: 10.1016/j.mycmed.2013.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 10/15/2013] [Accepted: 10/28/2013] [Indexed: 11/20/2022]
Abstract
The Mobile Team of Parasitology-Mycology is a movable entity of the Parasitology-Mycology laboratory of Tours University Hospital, France. In contrast to the usual prerogatives of biomedical laboratories, the Mobile Team of Parasitology-Mycology is requested to intervene directly at bedside in various clinical departments, or even outside the hospital facility. Although its actions are of course primarily devoted to specialized diagnostic and therapeutic purposes, the Mobile Team also plays an important educational role in the medical training of undergraduate or graduate students.
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Affiliation(s)
- G Desoubeaux
- Service de parasitologie, mycologie, médecine tropicale, laboratoire de biologie médicale, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, bâtiment B2A, 1(er) étage, 37044 Tours cedex 09, France; CEPR, unité Inserm U1100/EA 6305, faculté de médecine, université François-Rabelais de Tours, 10, boulevard Tonnellé, 37032 Tours cedex 01, France.
| | - E G Simon
- Commission pédagogique ECN, faculté de médecine, université François-Rabelais de Tours, 10, boulevard Tonnellé, 37032 Tours cedex 01, France; UMR Inserm U930/équipe 5, université François-Rabelais de Tours, 10, boulevard Tonnellé, 37032 Tours cedex 01, France
| | - D Perrotin
- Commission pédagogique ECN, faculté de médecine, université François-Rabelais de Tours, 10, boulevard Tonnellé, 37032 Tours cedex 01, France; Direction décanale de la faculté de médecine, université François-Rabelais de Tours, 10, boulevard Tonnellé, 37032 Tours cedex 01, France
| | - J Chandenier
- Service de parasitologie, mycologie, médecine tropicale, laboratoire de biologie médicale, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, bâtiment B2A, 1(er) étage, 37044 Tours cedex 09, France; CEPR, unité Inserm U1100/EA 6305, faculté de médecine, université François-Rabelais de Tours, 10, boulevard Tonnellé, 37032 Tours cedex 01, France
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