A 30 year old male with history of high grade fever with rigors followed by profuse sweating is admitted in ICU care after an episode of generalised tonic clonic seizure. The patient was comatose with no focal neurological deficit or signs of meningeal irrritation. The eyes were divergent, pout reflex was present. An impoant cause of death in this setting is:
Correct Answer: Acidosis
Description: Here the clinical features are suggestive of cerebral malaria. FACTS: Coma is a characteristic feature of falciparum malaria Death - 20 % despite treatment Onset - gradual/sudden following a convulsion Diffuse symmetric encephalopathy without any focal deficits Cerebral Malaria - Impoant complications: Hypoglycemia - common complication and with poor prognosis Acidosis - An impoant cause of death from cerebral malaria ARDS Renal Impairment Ref: Harrison, Edition - 18, page - 1692.
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