Journal
FUTURE MICROBIOLOGY
Volume 6, Issue 3, Pages 349-355Publisher
FUTURE MEDICINE LTD
DOI: 10.2217/FMB.11.3
Keywords
cerebral malaria; papilledema; retinopathy
Categories
Funding
- NIAID NIH HHS [U01 AI045955-06, U01 AI045955, U01 AI045955-07, U01 AI045955-10, U01 AI045955-09, U01 AI045955-08] Funding Source: Medline
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Accurate diagnosis of cerebral malaria (CM) is important for patient management, epidemiological and end point surveillance, and enrolling patients with CM in studies of pathogenesis or therapeutic trials. In malaria-endemic areas, where asymptomatic Plasmodium falciparum parasitemia is common, a positive blood film in a comatose individual does not prove that the coma is due to malaria. A retinopathy consisting of two unique features patchy retinal whitening and focal changes of vessel color - is highly specific for encephalopathy of malarial etiology. White-centered retinal hemorrhages are a common but less specific feature. Either indirect or direct ophthalmoscopy can be used to identify the changes, and both procedures can be learned and practiced by nonspecialist clinicians. In view of its important contributions to both clinical care and research, examination of the retina should become a routine component of the assessment of a comatose child or adult when CM is a possible diagnosis.
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