• Trans. R. Soc. Trop. Med. Hyg. · Mar 1996

    Retinal findings predictive of outcome in cerebral malaria.

    • S Lewallen, H Bakker, T E Taylor, B A Wills, P Courtright, and M E Molyneux.
    • International Eye Foundation, Blantyre, Malawi.
    • Trans. R. Soc. Trop. Med. Hyg. 1996 Mar 1;90(2):144-6.

    AbstractThe pathogenesis of cerebral malaria is poorly understood. Direct and indirect ophthalmoscope examinations of 141 Malawian children with strictly defined cerebral malaria revealed 2 distinct and prognostically significant findings: papilloedema and extramacular retinal oedema. The relative risk of death in patients with papilloedema was 6.7 times that in patients without papilloedema. Extramacular retinal oedema was associated with a 2.9 fold increase in the relative risk of dying. The mortality rate in patients with neither of these signs was only 1.3% compared to an overall mortality rate of 9.2%. The clinical and laboratory features associated with each of these ophthalmological findings were different, suggesting that there may be at least 2 different pathogenetic processes in patients with cerebral malaria.

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