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Symptoms are nonspecific, ranging from fevers, headache, malaise, myalgia, gastrointestinal distress to confusion, seizures or coma. Fever is the most characteristic feature of the illness and periodic febrile responses correspond to rupture of mature schizonts from erythrocytes. Diagnosis should be considered with anyone with fever of unknown origin regardless of travel history. Plasmodium falciparum is the most likely to cause severe malaria. Severe malaria is defined by the Centers for Diseases Control (CDC), when there is high burden of parasitemia and evidence of end organ dysfunction spanning across central nervous, cardiovascular, respiratory, renal and hematological systems. This entity needs prompt diagnosis and treatment. Despite recommendations and approval by the FDA, IV artesunate is not readily available at most hospitals in the United States.<\/jats:p>","DOI":"10.56305\/001c.140959","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T14:30:41Z","timestamp":1751380241000},"source":"Crossref","is-referenced-by-count":2,"title":["Fatal Cerebral Malaria in a Returning Traveler: Challenges in Recognition, Treatment, and Resource Accessibility in the United States"],"prefix":"10.56305","volume":"4","author":[{"given":"Sarah G","family":"Perry","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04vmvtb21","id-type":"ROR","asserted-by":"publisher"}],"name":"Tulane University","department":["Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Himmat","family":"Grewal","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04vmvtb21","id-type":"ROR","asserted-by":"publisher"}],"name":"Tulane University","department":["Division of Pulmonary Diseases; Critical Care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coralia","family":"Castillo","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04vmvtb21","id-type":"ROR","asserted-by":"publisher"}],"name":"Tulane University","department":["Division of Pulmonary Diseases, Critical Care Fellow"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon","family":"Love","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05ect4e57","id-type":"ROR","asserted-by":"publisher"}],"name":"Louisiana State University","department":["Chairman, Department of Pathology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayesha","family":"Younus","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05ect4e57","id-type":"ROR","asserted-by":"publisher"}],"name":"Louisiana State University","department":["Department of Pathology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"35509","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"ref1","article-title":"Evaluation and Diagnosis","author":"CDC","year":"2024","journal-title":"Malaria"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"101","DOI":"10.18700\/jnc.230034","article-title":"A case report of pitfall of fever and altered mental status: cerebral malaria due to Plasmodium falciparum in an adult traveler returning from Congo","volume":"16","author":"S.-H. 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