Abstract
BACKGROUND: Malaria, caused by parasites of the Plasmodium genus and transmitted by Anopheles mosquitoes, remains a global public health issue, with a high incidence in tropical and subtropical regions. Although Plasmodium falciparum is the main cause of severe cases, Plasmodium vivax can also lead to serious complications, including cerebral malaria. CASE PRESENTATION: This case report presents the case of a 43-year-old woman from the southwestern Pacific coast, Colombia, who developed severe neurological symptoms with an initially unclear diagnosis. A thick blood smear confirmed P. vivax infection. She was treated with intravenous artesunate and subsequently with chloroquine and primaquine, and she achieved a full recovery. CONCLUSIONS: Cerebral malaria has traditionally been associated with P. falciparum, P. vivax can also cause it through mechanical and inflammatory mechanisms, with a complex pathophysiology and potentially fatal outcomes. Early treatment with parenteral artesunate and intensive supportive care is key to improving outcomes.