From the Guidelines
CT scans are not the primary diagnostic tool for malaria, but they can show secondary complications such as cerebral malaria, splenomegaly, hepatomegaly, or pulmonary edema in severe cases, as indicated by the 2024 study on managing adult patients with malaria in non-endemic settings 1. When considering the diagnosis of malaria-like illness on a CT scan, it's essential to prioritize the clinical presentation and laboratory findings. The 2024 study 1 outlines the WHO epidemiological and research criteria for severe malaria, which includes signs and symptoms such as impaired consciousness, multiple convulsions, prostration, and bleeding, as well as laboratory and radiology findings like acidosis, hyperlactataemia, and severe anaemia. Some key findings on CT scans that may suggest malaria or its complications include:
- Cerebral malaria, presenting as brain swelling, small hemorrhages, or areas of ischemia in the brain
- Splenomegaly (enlarged spleen)
- Hepatomegaly (enlarged liver)
- Pulmonary edema in cases with respiratory involvement However, these findings are nonspecific and can be caused by many other conditions. Therefore, if malaria is suspected based on symptoms like cyclical fevers, chills, headache, and travel history to endemic areas, immediate blood testing is essential rather than CT imaging 1. It's crucial to note that treatment should not be delayed for imaging studies, as prompt administration of appropriate antimalarial medications like artemisinin-based combination therapies for P. falciparum or chloroquine for sensitive strains is crucial for preventing complications and reducing mortality, as outlined in the 2024 study 1.
From the Research
Malaria-like Illness on CT Scan
There are no research papers to assist in answering this question, as the provided studies focus on the treatment and efficacy of artemisinin-based combination therapies for uncomplicated and severe Plasmodium falciparum malaria, rather than the signs of malaria-like illness on CT scans.
- The studies discuss the use of artemisinin-based combination therapies, such as artemether-lumefantrine, artesunate-amodiaquine, and dihydroartemisinin-piperaquine, for the treatment of uncomplicated and severe malaria 2, 3, 4, 5.
- They also report on the efficacy and safety of these therapies, including their potential for asymptomatic liver enzyme abnormalities 3.
- However, none of the studies provide information on the signs of malaria-like illness on CT scans, making it impossible to provide a definitive answer to this question based on the available evidence 2, 3, 4, 5, 6.