PATHOPHYSIOLOGICAL AND PROGNOSTIC SIGNIFICANCE OF CEREBROSPINAL-FLUID LACTATE IN CEREBRAL MALARIA

Abstract

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. © 1985.