New concepts in treatment of malignant tertian malaria with cerebral involvement

Of 140 patients with malignant tertian malaria seen during 1956 to 1967 10 died. Death was caused by cerebral malaria in all cases. Since 1968 more intensified treatment has resulted in the complete recovery of three patients and the partial recovery of one, all of whom had been in a cerebral malaria coma for various periods of time before admission and in whom a fatal outcome was expected. In these cases a polypragmatic therapeutic approach using intravenous low molecular weight dextran, besides the usual quinine and fluids, corticosteroids, heparin and urea, separately or combined, was adopted.