Travel destinations were Africa (n = 32; 57.2%), Europe (n = 11; 19.5%), Asia (n = 7; 12.5%), the Caribbean (n = 2; 3.6%), Indian Ocean (n = 2; 3.6%), Pacific Ocean (n = 1; 1.8%), and Latin America (n = 1; 1.8%). Median duration of travel, for the 49 non-expatriates, was 21 days (25–75 IQ: 12–60 d). Table 1 shows the demographics and travel characteristics according to destination. Among the 31 travelers (55%) who stayed in endemic regions of malaria, only 9 (29%) had an optimal compliance with malaria chemoprophylaxis. Symptoms began during

travel in 20 patients (35.71%). As for the remaining 36 travelers, the median interval between return and clinical onset was 10 days (25–75 IQ: 4–14 d). Among the 20 patients who developed symptoms abroad, 15 (75%) consulted a local doctor of whom 11 buy HM781-36B (55%) required a medical evacuation. The median

interval between clinical onset and hospitalization, for all patients, was 4 days Ensartinib (25–75 IQ: 1.5–7 d). Due to initial wrong diagnosis (Table 2), a late management occurred in 20 cases with an average delay of 6.9 days (range: 1–50 d). Fever, headaches, and neck stiffness were the most common clinical features (Table 3) and all three were present in 50% of cases. The patients presented with a meningeal syndrome in 24 cases, whereas 20 others had an encephalitic presentation. The remaining 12 (21%) patients had an incomplete clinical presentation (headaches or fever). By comparing cerebral malaria with the other 44 diagnoses, it was noted that jaundice, Florfenicol dyspnea, and splenomegaly were significantly more

likely in malaria (p < 0.05). However, there was neither neck stiffness, rash, focal neurological findings nor lymphadenopathies in malaria. The analysis of full blood count showed that lymphocytopenia and thrombocytopenia were significantly lower (p < 0.05) in malaria-related CMI. In addition, we observed one case of eosinophilia (neurocysticercosis). As for biochemistry tests, CRP and total bilirubinemia were significantly higher in malaria cases (p < 0.05 and p < 0.005, respectively). Regarding the other etiologies, CRP was not discriminating; it was high in 42% of the confirmed viral CMI. The diagnosis of meningitis or encephalitis was confirmed in 43 patients by a pleiocytosis on lumbar puncture. The cytological analysis and CSF biochemical markers (protein and glucose concentrations) did not seem discriminating between etiologies. Thus, 25% (n = 6) of the confirmed viral CMI had a neutrophilic or mixed CSF formula, 46% (n = 11) had a protein concentration >1 g/L, and 12.5% (n = 3) had a low glucose concentration. Seventeen patients underwent a brain CT scan, 18 a brain MRI, and one a lumbar spine MRI. Among them, nine patients had a brain CT scan followed by a MRI. In all, seven morphological investigations were abnormal.