Cerebral malaria in children with cyanotic heart diseases: the need for a closer look.

We report four cases of encephalopathy admitted with fever, hypercyanosis, breathlessness, deep coma and convulsions considered of interest because these children had cyanotic heart diseases and concomitant cerebral malaria. Their presenting clinical features, which suggested cerebral malaria (decreased level of consciousness ranging in severity from drowsiness and severe headache to confusion, delirium and even deep coma) may equally characterise hypercyanotic episodes among children with uncorrected cyanotic cardiac defects. We also inferred that children with cyanotic cardiac defects may be prone to cerebral malaria and that those residing in the tropics may benefit from anti-malarial prophylaxis.