Cerebral malaria or meningitis?

Cerebral malaria is prevalent in Pakistan and is a major community health problem, therefore, accurate and easier methods of its diagnosis are needed at primary health care level. Over a span of 3 years [August 1993 to July 1996], nine febrile, comatosed patients with neck stiffness due to cerebral malaria, initially diagnosed as meningitis, were seen. This rare presentation of cerebral malaria was suspected, in a falciparum positive patient. CSF examination showed a neutrophil count of more than 1000/mm[3] and glucose less than 40% of the blood glucose level. Blood smears for malarial parasites are valuable in establishing the diagnosis in all clinically suspected patients of meningitis