Which is not a feature of cerebral malaria?
**Core Concept**
Cerebral malaria is a severe complication of Plasmodium falciparum infection, characterized by the sequestration of infected erythrocytes in the cerebral microvasculature. This leads to impaired blood flow, inflammation, and neuronal damage. The pathophysiology involves the binding of infected erythrocytes to the endothelial walls of cerebral blood vessels via the adhesion molecule CD36 and the cytoadherence receptor ICAM-1.
**Why the Correct Answer is Right**
The clinical presentation of cerebral malaria includes coma, seizures, and impaired consciousness. The presence of these symptoms is a result of the disruption of normal brain function due to the sequestration of infected erythrocytes in the cerebral microvasculature. The increased intracranial pressure and inflammation associated with cerebral malaria contribute to the development of these symptoms.
**Why Each Wrong Option is Incorrect**
**Option A:** Cerebral malaria is characterized by the presence of coma, which is a feature of this condition.
**Option B:** Seizures are a common symptom of cerebral malaria, making this option incorrect.
**Option C:** Impaired consciousness is a hallmark of cerebral malaria, making this option incorrect as well.
**Clinical Pearl / High-Yield Fact**
Cerebral malaria is a medical emergency that requires prompt recognition and treatment. Early diagnosis and initiation of antimalarial therapy, such as artesunate, can significantly improve outcomes and reduce mortality.
**Correct Answer:** D.