A 5yo child came from Ghana 6wks ago. 2d ago he developed fever, vomiting and neck stiffness. He had taken malaria prophylaxis and had no rash. What is the dx?

The key is B. Cerebral malaria. [Incubation period of malaria is 7 – 30 days. Malaria prophylaxis

cannot give confirmed protection and there is often failure of prophylaxis. Fever, vomiting, neck

stiffness are consistent with cerebral malaria. In meningococcal disease there may be rash. However

meningococcal meningitis may be without rash. But Ghana is endemic zone for malaria. So cerebral

malaria is a more strong probability].