Skip to main content

Advertisement

SpringerLink
Log in

Differentiating the pathologies of cerebral malaria by postmortem parasite counts

  • Brief Communication
  • Published:

From Nature Medicine

View current issue Submit your manuscript

A Corrigendum to this article was published on 01 April 2004

Abstract

To study the pathogenesis of fatal cerebral malaria, we conducted autopsies in 31 children with this clinical diagnosis. We found that 23% of the children had actually died from other causes. The remaining patients had parasites sequestered in cerebral capillaries, and 75% of those had additional intra- and perivascular pathology. Retinopathy was the only clinical sign distinguishing malarial from nonmalarial coma. These data have implications for treating malaria patients, designing clinical trials and assessing malaria-specific disease associations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1: Pathological features in patients who died of clinically defined cerebral malaria.
Figure 2: Scatter plots of various parasitic elements in patients with clinically defined cerebral malaria and control patients, based on counts of at least 100 cerebral capillaries.

Similar content being viewed by others

References

  1. Newton, C.R.J.C., Taylor, T.E. & Whitten, R.O. Am. J. Trop. Med. Hyg. 58, 673–683 (1998).

    Article  CAS  Google Scholar 

  2. Marsh, K., English, M. & Crawley, J. Ann. Trop. Med. Parasitol. 90, 395–402 (1996).

    Article  CAS  Google Scholar 

  3. Silamut, K. & White, N.J. Trans. R. Soc. Trop. Med. Hyg. 87, 436–443 (1993).

    Article  CAS  Google Scholar 

  4. Bolton, C.F., Young, G.B. & Zochodne, D.E. Ann. Neurol. 33, 94–100 (1993).

    Article  CAS  Google Scholar 

  5. Breiman, L., Friedman, J.H., Olshen, R.A. & Stone, C.J. in Classification and Regression Trees (Chapman and Hall/CRC, London, 1993).

    Google Scholar 

  6. Lewallen, S. et al. Trans. R. Soc. Trop. Med. Hyg. 93, 619–622 (1999).

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by the US National Institutes of Health (RO1 AO34969) and The Wellcome Trust (042390/Z/94). W.F. is partly supported by the US National Cancer Institute/National Institutes of Health (CA 90301). Many clinicians provided patient care (see Supplementary Note online). For conducting the autopsies, we thank mortuary attendants D. Kotokwa and W. Namanya, and pathologists M. Appleton, D. Barrowcliff, R. Bazinet, D. Connor, T. Kovan, F. MacInnes, H. Manz, D. Milner, A. Oviedo, U. Mahadeva, E. Pollina, C. Richards, C. Richert, L. Stein, R. Tozer, G. Vischer and V. White. We thank the patients' families for the privilege of conducting these autopsies, A. Indurkhya for early statistical input, S. Rogerson for reviewing the manuscript and P. Marsh for nutritional support.

Author information

Author notes

  1. Wenjiang J Fu

    Present address: Department of Statistics, Texas A&M University, College Station, Texas, 77843, USA

Authors and Affiliations

  1. Department of Internal Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, 48824, Michigan, USA

    Terrie E Taylor

  2. Blantyre Malaria Project, PO Box 30096, Blantyre, 3, Malawi

    Terrie E Taylor & Nedson G Fosiko

  3. Department of Epidemiology, Michigan State University, East Lansing, 48824, Michigan, USA

    Wenjiang J Fu

  4. South Warwickshire General Hospitals NHS Trust, Pathology Laboratory, Lakin Road, Warwick, CV34 5BH, UK

    Richard A Carr

  5. Black Hills Pathology, 413 Lilly Road NE, Olympia, 98506, Washington, USA

    Richard O Whitten

  6. Department of Pathology, C-3321 Medical Center North, Vanderbilt University School of Medicine, Nashville, 37232-2561, Tennessee, USA

    Jeffrey G Mueller

  7. Kilimanjaro Centre for Community Ophthalmology, Tumaini University/KCMC, PO Box 225, Moshi, Tanzania

    Susan Lewallen

  8. Department of Histopathology, University of Malawi College of Medicine, Blantyre, 3, Malawi

    N George Liomba

  9. Malawi-Liverpool-Wellcome Trust Clinical Research Programme, PO Box 30096, Blantyre, 3, Malawi

    Malcolm E Molyneux

  10. Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK

    Malcolm E Molyneux

Authors
  1. Terrie E Taylor
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wenjiang J Fu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Richard A Carr
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Richard O Whitten
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jeffrey G Mueller
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nedson G Fosiko
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Susan Lewallen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. N George Liomba
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Malcolm E Molyneux
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Terrie E Taylor.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Cite this article

Taylor, T., Fu, W., Carr, R. et al. Differentiating the pathologies of cerebral malaria by postmortem parasite counts. Nat Med 10, 143–145 (2004). https://doi.org/10.1038/nm986

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nm986

  • Springer Nature America, Inc.

This article is cited by

Search

Navigation