Description
A 22 year old student presented with bi-frontal headaches and intermittent fevers after Returning to the UK three weeks earlier from a six month trekking holiday round Malawi and Southern and Eastern Africa. His mother had noticed a change in his personality. He was listless, apathetic and displayed uncharacteristic aggressive outbursts. His sleep patter was repeatedly disturbed by vivid nightmares. His mother also observed episodes of confusion which were sometimes accompanied by a feeling of d??j vu. During the 24 hours prior to admission his balance was impaired and he began to complain of weakness of his right upper limb. He had not taken any malaria prophylaxis and during his trip he had suffered three episodes of rigors, each lasting 24 hours, for which he had been prescribed Halofantrine Four weeks prior to returning to the UK he had undertaken a one week scuba-diving course in Lake Malawi. There was no other significant freshwater exposure.
