Cerebral malaria is caused by plasmodium –
**Core Concept**
Cerebral malaria is a severe complication of Plasmodium infection that leads to cerebral edema, coma, and death. It is characterized by the sequestration of infected erythrocytes in the microvasculature of the brain. The pathogenesis involves the adherence of infected red blood cells to the endothelium, leading to microvascular obstruction and inflammation.
**Why the Correct Answer is Right**
The correct answer is Plasmodium falciparum. This parasite causes the most severe form of malaria, with a high propensity for cerebral involvement. The infected erythrocytes express surface antigens such as VAR2CSA, which binds to chondroitin sulfate A on the brain endothelium, facilitating their sequestration in the cerebral microvasculature. The resulting microvascular obstruction leads to cerebral edema, inflammation, and increased intracranial pressure.
**Why Each Wrong Option is Incorrect**
**Option A:** Plasmodium vivax - While Plasmodium vivax can cause relapsing malaria, it is less commonly associated with cerebral malaria and typically does not lead to the same level of microvascular obstruction as Plasmodium falciparum.
**Option B:** Plasmodium ovale - Plasmodium ovale is another species that causes relapsing malaria, but it is not typically associated with cerebral malaria.
**Option C:** Plasmodium malariae - Plasmodium malariae is a cause of quartan malaria, which can lead to nephrotic syndrome and other complications, but it is not commonly associated with cerebral malaria.
**Clinical Pearl / High-Yield Fact**
The presence of coma, seizures, or altered mental status in a patient with malaria should raise suspicion for cerebral malaria, which requires prompt treatment with intravenous antimalarial therapy.
**Correct Answer:** C.