Malaria

Malaria is a very significant cause of morbidity and mortality. At least one million people of all ages die of malaria every year. For the radiologist, the only significant imaging abnormality in the patient with malaria (apart from the large spleen) is the fortunately uncommon development of severe bilateral pulmonary oedema. This has no radiological characteristics to differentiate it from pulmonary oedema of any other aetiology. It is important to be aware that this pulmonary oedema is an intrinsic complication of severe malaria and does not have to be the result of fluid overload or any other therapy. It is very difficult to treat and can be fatal. Generalised oedema may be the result of malarial nephropathy/ glomerulonephritis. There are no distinguishing features on imaging.

In infants, cerebral malaria can cause cerebral oedema and suture diastasis (separation) might be mistaken for an intracranial tumour, especially when the child lapses into a coma.

The splenomegaly of malaria can be gross, but the ultrasound appearance remains homogeneous. Pressure distortion and displacement of the left kidney can occur.

Philip E.S. Palmer, with Stanley P. Bohrer, Carlos Bruguera, Xing-Rong Chen, Mahmoud R. EImeligi, Hassen A. Gharbi, S.B. Lagundoye, M. W. Wachira