Document Detail


Diagnostic issues in cerebral malaria: a study of 112 adolescents and adults in Lagos, Nigeria.
MedLine Citation:
PMID:  15254565     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
N U Okubadejo; M A Danesi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Nigerian postgraduate medical journal     Volume:  11     ISSN:  1117-1936     ISO Abbreviation:  Niger Postgrad Med J     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-07-19     Completed Date:  2004-09-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9613595     Medline TA:  Niger Postgrad Med J     Country:  Nigeria    
Other Details:
Languages:  eng     Pagination:  10-4     Citation Subset:  IM    
Affiliation:
Department of Medicine, College of Medicine, University of Lagos, Nigeria.
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MeSH Terms
Descriptor/Qualifier:
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

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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