[Current aspects on cerebral malaria in the non-immune patient in African endemic areas].
The current clinical and therapeutic aspects of cerebral malaria in non-immune adult subjects living in endemic areas of Africa were evaluated in 10 men (mean age: 40 + or - 11, 4 years). On admission, 8 patients had fever, 3 were truly comatose with a Glasgow score of 7 or more. All had negative central venous pressure and only one was in a state of hyperkinetic shock. Respiratory symptoms were present in 8 cases, and jaundice was observed in 8 cases. Three patients has a haemoglobin level lower than 8 g/100 ml, and 8 had thrombocytopenia. Blood creatinine levels above 240 umol/l and blood bilirubin levels above 50 umol/l were found in 6 and 8 patients respectively. Plasma creatine phosphokinase was above 500 iu/l in 7 cases, and PaO2 was above 70 mmHg in 7 cases. All patients received quinine, combined with doxycycline in 6 cases. Infectious complications occurred in 5 patients, with 2 septic shocks. Two patients developed acute pulmonary oedema. Five patients died. This study shows that cerebral malaria in non-immune subjects living in endemic areas produces multivisceral deficiency similar to that observed in imported malaria. Its prognosis can be improved by loading doses of quinine and by a better prevention of nosocomial infections.
Vitris
M
M
Service de réanimation hôpital Principal.
Saissy
J M
JM
Demaziere
J
J
Gaye
M
M
Seck
M
M
Marcoux
L
L
Ndiaye
M
M
D000328:Adult; D000349:Africa; D006801:Humans; D016779:Malaria, Cerebral / Q000150:complications / Q000175:diagnosis* / Q000276:immunology*; D008297:Male; D008875:Middle Aged
Aspects actuels du neuropaludisme chez le sujet non immun en zone d'endémie africaine.