Cerebrospinal-fluid (CSF) lactate concentrations were elevated in all but 1 of 45 patients with cerebral malaria. They were significantly higher in patients who died (9·0±5·3 mmol/l, mean±SD) than in survivors (3·4±1·1 mmol/l, p=0·0002) and had returned to normal values in each of 9 patients studied after recovery of consciousness. There was a significant negative correlation between CSF lactate and CSF glucose. All 11 patients with CSF lactate concentrations above 6 mmol/l died. CSF lactate is thus an important prognostic indicator in cerebral malaria and these findings suggest that hypoxia contributes to the pathogenesis of this disorder.
Isabelle M. Medana, Tran Tinh Hien, Nicholas Day, Nguyen Hoan Phu, Nguyen Thi Hoang, Ly Van Chuong, Tran Thi Hong Chau, Anne Taylor, Houta Salahifar, Roland Stocker, George A. Smythe, Gareth D. H. Turner, Jeremy Farrar, Sir Nicholas White, Nicholas H. Hunt
Narcisse Ndieugnou Djangang, Pamela Ramunno, Antonio Izzi, Alessandra Garufi, Marco Menozzi, Daniela Diaferia, Lorenzo Peluso, Chiara Prezioso, Marta Talamonti, Hassane Njimi, Sophie Schuind, Jean Louis Vincent, Jacques Créteur, Fabio Silvio Taccone, Elisa Gouvêa Bogossian
Deborah Waller, Sanjeev Krishna, Jane Crawley, Katherine M. Miller, François Nosten, D. Chapman, Feiko O. ter Kuile, Charles Craddock, C. Berry, Pah Holloway, David Brewster, B. M. Greenwood, Sir Nicholas White
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