Differentiating the pathologies of cerebral malaria by postmortem parasite counts.
To study the pathogenesis of fatal cerebral malaria, we conducted autopsies in 31 children with this clinical diagnosis. We found that 23% of the children had actually died from other causes. The remaining patients had parasites sequestered in cerebral capillaries, and 75% of those had additional intra- and perivascular pathology. Retinopathy was the only clinical sign distinguishing malarial from nonmalarial coma. These data have implications for treating malaria patients, designing clinical trials and assessing malaria-specific disease associations.
Taylor
Terrie E
TE
Department of Internal Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan 48824, USA. taylort@msu.edu
Fu
Wenjiang J
WJ
Carr
Richard A
RA
Whitten
Richard O
RO
Mueller
Jeffrey S
JS
Fosiko
Nedson G
NG
Lewallen
Susan
S
Liomba
N George
NG
Molyneux
Malcolm E
ME
Mueller
Jeffrey G
JG
D000818:Animals; D001344:Autopsy; D001921:Brain / Q000469:parasitology / Q000473:pathology; D002196:Capillaries / Q000469:parasitology; D002423:Cause of Death; D002560:Cerebrovascular Circulation; D002648:Child; D003128:Coma; D006801:Humans; D016779:Malaria, Cerebral / Q000175:diagnosis / Q000401:mortality / Q000469:parasitology* / Q000473:pathology*; D010963:Plasmodium falciparum / Q000302:isolation & purification*