Authors: Lisa David Kyamarisi , Mukiza M Ngemera , Warles C Lwabukuna , Yassin Mgonda

Abstract

Background: Stroke is a rare but serious complication of malaria, especially with Plasmodium falciparum infection as a result of cerebral vessels obstruction by the parasitized red blood cells. Prompt recognition in malaria patients presenting with neurological symptoms is essential for effective management.

Case Presentation: A 32-year-old male with no prior cardiovascular risk factors developed acute neurological symptoms after treatment for confirmed malaria. Brain imaging showed multifocal ischemic infarcts. Comprehensive investigations excluded common causes of stroke, including hypertension, diabetes, coagulopathies, and cardiac sources of embolism as well as vasculitis. The close timing between malaria infection and strokes, along with the absence of alternative explanations, supported a diagnosis of malaria-associated ischemic stroke. The patient continued antimalarial therapy and received supportive care including physiotherapy. Over subsequent day, neurological deficits gradually improved with rehabilitation.

Conclusion: Malaria-induced stroke, though uncommon, should be considered in young patients presenting with acute neurological deficits in endemic areas. Early diagnosis and integrated management of both malaria and stroke can improve patient outcome and reduce disability. Increased awareness among clinicians is important to identify this rare but treatable complication.

Keywords: Malaria-induced, ischemic stroke, severe malaria, Plasmodium falciparum, case report.