Dexamethasone in Cerebral Malaria

Abstract

To the Editor: I congratulate Warrell et al. (February 11 issue) for their important controlled study of coma due to falciparum malaria, which showed that dexamethasone increased the duration of coma and the incidence of complications.1The low overall fatality rate of 17 per cent is noteworthy and a reflection of the quality of treatment. The authors did not state how many patients became comatose after entering the hospital and after receiving treatment with intravenous infusions of quinine. Quinine can cause coma,2and as can fluid overload2(possibly because of cerebral edema) and pulmonary edema; the latter developed in 10. © 1982, Massachusetts Medical Society. All rights reserved.