| Diagnostic issues in cerebral malaria: a study of 112 adolescents and adults in Lagos, Nigeria. | |
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MedLine Citation:
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PMID: 15254565 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine the accuracy of initial diagnosis of cerebral malaria in adolescents and adults presenting at our tertiary centre and identify the clinical and laboratory parameters helpful in distinguishing cerebral malaria from other differential diagnosis. METHODS: A retrospective review of 112 adolescents and adults initially diagnosed as having cerebral malaria was carried out. Clinical features (risk factors, mode of presentation, clinical course and final diagnosis) and laboratory parameters (level of parasitaemia, haematologic and biochemical values) were documented. RESULTS: A correct diagnosis was made in 52 patients (46.4%), with septicaemia (20.5%) and meningitis (15.2%) accounting for most misdiagnosis. The majority of correctly diagnosed were aged 11-25 years (92.3%), and a predisposing factor was identifiable in 46.2%. Parasitaemia was predominantly moderate to heavy in correctly diagnosed cases, compared to those misdiagnosed in whom it was mild to moderate. Case fatality was higher for misdiagnosed cases (18.6%). CONCLUSION: The probability of an alternate diagnosis amenable to other treatment regimes should always be explored. This is particularly important in patients of middle age and those with either absent predisposing factors or mild parasitaemia, in order to reduce case fatality. |
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Authors:
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N U Okubadejo; M A Danesi |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Nigerian postgraduate medical journal Volume: 11 ISSN: 1117-1936 ISO Abbreviation: Niger Postgrad Med J Publication Date: 2004 Mar |
Date Detail:
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Created Date: 2004-07-19 Completed Date: 2004-09-23 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9613595 Medline TA: Niger Postgrad Med J Country: Nigeria |
Other Details:
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Languages: eng Pagination: 10-4 Citation Subset: IM |
Affiliation:
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Department of Medicine, College of Medicine, University of Lagos, Nigeria. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Child Coma / etiology Diagnostic Errors* Fever / etiology Humans Malaria, Cerebral / complications, diagnosis* Middle Aged Nigeria Parasitemia / complications Precipitating Factors Prognosis Reproducibility of Results Retrospective Studies Seizures / etiology |
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