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Am J Trop Med Hyg. 2013 Nov;89(5):866-8. doi: 10.4269/ajtmh.13-0281. Epub 2013 Sep 9.

Prevalence and implications of cerebrospinal fluid leukocytosis in Papua New Guinean children hospitalized with severe malaria.

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  • 1School 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.

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.

PMID:
24019433
[PubMed - indexed for MEDLINE]
PMCID:
PMC3820327
[Available on 2014/11/6]
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