title: Prevalence and implications of cerebrospinal fluid leukocytosis in Papua New Guinean children hospitalized with severe malaria.
abstract: Cerebrospinal fluid (CSF) leukocytosis in severe malaria was assessed in 87 children in Papua New Guinea participating in a detailed longitudinal observational study who had undergone lumbar puncture for further investigation of altered consciousness and/or convulsions. After rigorous exclusion of non-malarial infection, 16 (20.5%) of 78 children with Plasmodium falciparum monoinfection but 0 of 9 with P. vivax/mixed-species malaria had a detectable CSF leukocytosis, which was unrelated to prior, including complex, seizures. There were eight children with a CSF leukocyte density > 10 cells/μL (9.2% of the total sample), half of whom had cerebral malaria (4 of 22, 18.1%). Cerebrospinal fluid leukocytosis is infrequent in severe pediatric malaria, especially in children with P. vivax infections, and it is generally mild. Its presence in a blood slide-positive child should prompt consideration of alternative diagnoses and empiric antibiotic therapy.
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Freemantle, Western Australia, Australia; Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea.
authors.forename: Moses
authors.initials: M
authors.lastname: Laman
authors.forename: Laurens
authors.initials: L
authors.lastname: Manning
authors.forename: Peter M
authors.initials: PM
authors.lastname: Siba
authors.forename: Timothy M E
authors.initials: TM
authors.lastname: Davis
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D060085:Coinfection; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007964:Leukocytosis / Q000134:cerebrospinal fluid* / Q000453:epidemiology / Q000469:parasitology / Q000503:physiopathology; D016779:Malaria, Cerebral / Q000134:cerebrospinal fluid* / Q000453:epidemiology / Q000469:parasitology / Q000503:physiopathology; D016778:Malaria, Falciparum / Q000134:cerebrospinal fluid* / Q000453:epidemiology / Q000469:parasitology / Q000503:physiopathology; D016780:Malaria, Vivax / Q000134:cerebrospinal fluid* / Q000453:epidemiology / Q000469:parasitology / Q000503:physiopathology; D008297:Male; D010219:Papua New Guinea / Q000453:epidemiology; D010963:Plasmodium falciparum / Q000472:pathogenicity / Q000502:physiology; D015995:Prevalence
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