Characteristic abnormalities in cerebrospinal fluid biochemistry in children with cerebral malaria compared to viral encephalitis

Jakka, S; Veena, Sargoor R.; Atmakuri, RM; Eisenhut, Michael

doi:10.1186/1743-8454-3-8

Cited by 12 publications

(5 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition to its significant value for the diagnosis of TBM, elevated CSF ADA levels can suggest other diseases, such as nontuberculous infectious meningitis ( 7 - 13 ), lymphoproliferative disorders ( 14 , 15 ), and autoimmune-related CNS disease ( 16 - 20 ). In particular, a recent retrospective study found that the elevation of ADA levels was a unique CSF finding in patients with autoimmune GFAP astrocytopathy ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

Self-remitting Elevation of Adenosine Deaminase Levels in the Cerebrospinal Fluid with Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy: A Case Report and Review of the Literature

et al. 2021

View full text Add to dashboard Cite

A 29-year-old man presented with a high-grade fever, headache, and urinary retention, in addition to meningeal irritation and myoclonus in his upper extremities. A cerebrospinal fluid (CSF) examination showed pleocytosis and high adenosine deaminase (ADA) levels with no evidence of bacterial infection, including Mycobacterium tuberculosis . T2-weighted brain magnetic resonance imaging showed transient hyper-intensity lesions at the splenium of the corpus callosum (SCC), bilateral putamen, and pons during the course of the disease. The CSF was positive for anti-glial fibrillary acidic protein (GFAP) antibodies. He was diagnosed with autoimmune GFAP astrocytopathy. The present case shows that the combination of an elevated ADA level in the CSF and reversible T2-weighted hyper-intensity on the SCC supports the diagnosis of autoimmune GFAP encephalopathy.

show abstract

Section: Discussionmentioning

confidence: 99%

Self-remitting Elevation of Adenosine Deaminase Levels in the Cerebrospinal Fluid with Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy: A Case Report and Review of the Literature

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Severe malaria can be clinically indistinguishable from other common illnesses including pneumonia, meningitis and sepsis9-17 and in endemic areas, microscopy or other tests to confirm parasitemia are commonly unavailable or unreliable 18-23. At 10 Tanzanian hospitals, 39% of ‘positive’ malaria slides were false positives and at 17 Kenyan outpatient clinics, the positive predictive value of a ‘positive’ slide was only 22% (negative predictive value 93%) when compared to expert microscopy 19,24.…”

Section: The Problems Of Diagnosismentioning

confidence: 99%

Over-Diagnosis and Co-Morbidity of Severe Malaria in African Children: A Guide for Clinicians

Gwer¹,

Newton²,

Berkley³

2007

The American Journal of Tropical Medicine and Hygiene

102

View full text Add to dashboard Cite

Severe malaria is clinically similar to other severe febrile illnesses. However, in endemic areas, parasitological confirmation of parasitemia is often unavailable or unreliable. False-positive malaria microscopy is common. The most important consequence of treating only for malaria when no parasitemia exists is failure to address other life-threatening conditions. Invasive bacterial infections are detected in up to one third of children with clinical features of severe malaria but a slide with results negative for malaria. Even among genuinely parasitized children, severe illness is not always due to malaria in endemic areas. We believe that routine use of parenteral antibiotics among children with a slide that indicates malaria and life-threatening disease is warranted because invasive bacterial infections are likely to be under-ascertained and are associated with increased mortality. Published data on co-morbidity with HIV infection and malnutrition are reviewed. A structured approach to assessment and care is essential, and is largely independent of underlying etiology.

show abstract

“…In our patient, CSF lactate levels could not be assessed, but there was mild pleocytosis and a marked increase in protein levels; glucose levels were normal. This marked increase of proteins and mild pleocytosis can also help differentiate viral encephalitis and bacterial meningitis, respectively [ 4 , 5 ]. Furthermore, CT scans and MRI in patients of cerebral malaria are usually normal or show edema and cortical or subcortical infarcts in the watershed zone in about 15% to 20% of patients [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Cerebral Malaria in a Patient with HIV, Hepatitis B, and Hepatitis C

Smm

Haq

et al. 2018

Cureus

View full text Add to dashboard Cite

Cerebral malaria is one of the most common causes of non-traumatic encephalopathy. A 25-year-old man who is a known intravenous and oral drug abuser presented to our clinic with fever and sore throat for two days prior and an altered level of consciousness for one day. On examination, the patient was icteric, and his Glasgow coma scale score on arrival was 10/15; he had dilated pupils reactive to light and a positive corneal reflex. All cranial nerves were intact; however, signs of meningeal irritation were positive. Motor examination showed an increased tone and rigidity in all limbs, patellar reflex was 3+, plantars were down-going, and clonus was negative. A fundoscopic examination was unremarkable. Additional investigations revealed he was positive for Plasmodium falciparum, HIV, hepatitis B, and hepatitis C. In addition, a test of his cerebrospinal fluid revealed evidence of cerebral malaria. We initiated artemether 120 mg, intravenous ceftriaxone 2 g, and 5% dextrose saline for the intermittent hypoglycemia. The patient’s condition eventually improved drastically. This case outlines the possible exacerbating effect of HIV on malaria, and it calls for HIV screening and staging alongside suspected malaria. This case also underlines the need for further evaluation of a potential protective role of hepatitis B and C to find an alternative therapeutic cure for malaria.

show abstract

Characteristic abnormalities in cerebrospinal fluid biochemistry in children with cerebral malaria compared to viral encephalitis

Cited by 12 publications

References 20 publications

Self-remitting Elevation of Adenosine Deaminase Levels in the Cerebrospinal Fluid with Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy: A Case Report and Review of the Literature

Self-remitting Elevation of Adenosine Deaminase Levels in the Cerebrospinal Fluid with Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy: A Case Report and Review of the Literature

Over-Diagnosis and Co-Morbidity of Severe Malaria in African Children: A Guide for Clinicians

Cerebral Malaria in a Patient with HIV, Hepatitis B, and Hepatitis C

Contact Info

Product

Resources

About