Pathophysiological and prognostic significance of cerebrospinal-fluid lactate in cerebral malaria.
Cerebrospinal-fluid (CSF) lactate concentrations were elevated in all but 1 of 45 patients with cerebral malaria. They were significantly higher in patients who died (9.0 +/- 5.3 mmol/l, mean +/- SD) than in survivors (3.4 +/- 1.1 mmol/l, p = 0.0002) and had returned to normal values in each of 9 patients studied after recovery of consciousness. There was a significant negative correlation between CSF lactate and CSF glucose. All 11 patients with CSF lactate concentrations above 6 mmol/l died. CSF lactate is thus an important prognostic indicator in cerebral malaria and these findings suggest that hypoxia contributes to the pathogenesis of this disorder.
White
N J
NJ
Warrell
D A
DA
Looareesuwan
S
S
Chanthavanich
P
P
Phillips
R E
RE
Pongpaew
P
P
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000378:metabolism; D001927:Brain Diseases / Q000378:metabolism*; D002648:Child; D005260:Female; D005947:Glucose / Q000134:cerebrospinal fluid / Q000378:metabolism; D006801:Humans; D007773:Lactates / Q000134:cerebrospinal fluid* / Q000378:metabolism; D008288:Malaria / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010963:Plasmodium falciparum; D011379:Prognosis
D007773:Lactates; D005947:Glucose