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 Release 22.0, Sept. 2008
 
Chapter : ch24. Parasitology & Medical Entomology Section : Malaria
  Differential Diagnosis of Psychosis in a Patient with Malaria

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Overview :

A patient with malaria may demonstrate signs of abnormal behavior or frank psychosis. The patient should be carefully evaluated for possible causes.

 

Possible Cause

Feature

exacerbation of a pre-existing psychotic disorder

history of previous psychotic disorder

cerebral malaria

altered level of consiousness or other signs of cerebral involvement; tends to last only a few days

viral encephalitis

possible exposure, serologic or virologic findings, skin rash or other findings, other neurologic findings

anti-malarial medication

reverses after drug discontinuation

other medication

reverses after drug discontinuation

alcohol withdrawal or psychosis

history of alcohol abuse

stress-related psychiatric disorder

past history of psychiatric disorder; severe stress (warfare, travel or weather related, etc)

 

Although anti-malarial drugs may be associated with psychiatric reactions it is important to exclude other causes before assuming this is the sole cause.

 

  References:

Warrell DA. Chapter 7: Clinical features of malaria. pages 191-205 (page 197; Table 7.5, page 204). IN: Warrell DA, Gilles HM (editors). Essential Malariology, Fourth Edition. Arnold. 2002.

 

 

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