It is discussed the case of cerebral paludism due to Plasmodium falciparum in a patient who travelled frequently to Ivory Coast and who had done an incorrect prophylaxis of paludism. It is underlined the relationship of cerebral presentation with the presence of multisystemic failure, which was characterized by respiratory distress, hyperdynamic shock, acute renal failure and hematological and digestive disorders. Shock forced the administration of vasoactive drugs (such as dopamine, dobutamine and methoxamine), respiratory failure to establish mechanical ventilation and coagulation disorders to transfuse platelets and plasma. Clinical evolution was favorable in few days thanks to an early symptomatic and etiology therapy.