Sequestration and microvascular congestion are associated with coma in human cerebral malaria.
J Infect Dis
; 205(4): 663-71, 2012 Feb 15.
Article
em En
| MEDLINE
| ID: mdl-22207648
ABSTRACT
The pathogenesis of coma in severe Plasmodium falciparum malaria remains poorly understood. Obstruction of the brain microvasculature because of sequestration of parasitized red blood cells (pRBCs) represents one mechanism that could contribute to coma in cerebral malaria. Quantitative postmortem microscopy of brain sections from Vietnamese adults dying of malaria confirmed that sequestration in the cerebral microvasculature was significantly higher in patients with cerebral malaria (CM; n = 21) than in patients with non-CM (n = 23). Sequestration of pRBCs and CM was also significantly associated with increased microvascular congestion by infected and uninfected erythrocytes. Clinicopathological correlation showed that sequestration and congestion were significantly associated with deeper levels of premortem coma and shorter time to death. Microvascular congestion and sequestration were highly correlated as microscopic findings but were independent predictors of a clinical diagnosis of CM. Increased microvascular congestion accompanies coma in CM, associated with parasite sequestration in the cerebral microvasculature.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Plasmodium falciparum
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Malária Falciparum
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Malária Cerebral
/
Coma
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Eritrócitos
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Microvasos
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Hiperemia
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
J Infect Dis
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Reino Unido