Irshad Ahmad Malik, Imran Lqbal, Suleman Malik.
A study of cerebral malaria at Multan.
Pak Paed J Jan ;20(4):175-80.

A clinical study of cerebral malaria was done in 25 children. Those cases with unarousable coma or altered conscious level and presence of asexual forms of plasmodium facliparum in peripheral blood film were included in the study. Common presenting symptoms of disease were fever, irritability and confusion, loss of consciousness and convulsions. Physical noticed in these children were anaemia, hepatosplenomegaly, low conscious level and abnormalities of muscle tone. Low haemoglobin was present in all the cases but other laboratory parameters were not significantly changed. Most of these children were initially treated with chloroquine. Chloroquine failure rate was fairly high (65%). Quinine was used for Chloroquine treatment failures. A combination of chloroquine followed by quinine gave the best results (60% curt rate). Neurological sequelae were noticed in 32% and the mortality was 20%. Poor prognostic features included age less than 5 years, intractable fits, low haemoglobin level, high leukocyte count. raised blood urea and creatinine and high CSF protein. Early diagnosis and treatment of cerebral malaria at primary care level and timely referrals are needed to reduce mortality and complications in these patients.

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