[Cerebral malaria in non-immune subjects. Current aspects 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 +/- 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 mumol/l and blood bilirubin levels above 50 mumol/l were found in 6 and 8 patients respectively. Plasma creatine phosphokinase was above 500 IU/l in 7 cases, and PaO2 was below 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.
Saissy
J M
JM
Service de Réanimation, Hôpital Principal, Dakar, Sénégal.
Kempf
J
J
Demazière
J
J
Gaye
M
M
Seck
M
M
Diatta
B
B
D058186:Acute Kidney Injury / Q000209:etiology; D000328:Adult; D000349:Africa; D001927:Brain Diseases / Q000209:etiology* / Q000469:parasitology; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000469:parasitology; D006801:Humans; D008171:Lung Diseases / Q000209:etiology* / Q000469:parasitology; D008288:Malaria / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011803:Quinine / Q000627:therapeutic use*; D012189:Retrospective Studies; D012772:Shock, Septic / Q000209:etiology; D013997:Time Factors
D011803:Quinine
Neuropaludisme chez le sujet non immun. Aspects actuels en zone d'endémie africaine.