Postmortem diagnosis of cerebral malaria

Human cerebral malaria is a frequent encephalopathy that occurs in the endemic tropical-subtropical zones. There are a smaller number of imported cases in continental zones where the diagnosis sometimes remains difficult to establish. Fifteen days after the death of a 36-year-old male French citizen in Africa, an investigation to determine the cause of death was conducted. Histologic examination of the brain permitted the diagnosis of cerebral malaria. Because of the popularity of overseas tourism and because this disorder may appear as "sudden death," these victims may be referred to a forensic pathologist. This case demonstrates the role a forensic pathologist may play in determining the cause of death in cerebral malaria.     

Book Reviews

Book reviewed in this article: STRIKES: Studies in Twentieth Century Australian Social History. Edited by John Iremonger, John Merrit and Graeme Osborne. THE STUART AFFAIR. By Sir Roderic Chamberlain. THE EVIDENCE OF THE BIGGE REPORTS: New South Wales under Governor Macquarie. Selected and edited by John Ritchie. HISTORICAL RECORDS OF PORT PHILLIP: The First Annals of the Colony of Victoria. Edited by John J. Shillinglaw. THE MACQUARIE DECADE: Documents illustrating the History of New South Wales 1810–1821. AUSTRALIAN NAVAL ADMINISTRATION 1900–1939. By R. Hyslop. CRISES AND AUSTRALIAN DIPLOMACY. By C. Bell. BRITISH DEFENCE POLICY EAST OF SUEZ. By P. Darby. DEFENCE PERSPECTIVES. Edited by K. Keith. THE MODERNISATION IMPERATIVE AND INDIAN PLANNING. By Baldev Raj Nayar. INDIA'S DEMOCRACY. By A.H. Hanson and Janet Douglas. London, Weidenfeld and Nicolson, 1972. Pp. 236. Two tables. $9.65, $4.35 paper. GANDHI'S RISE TO POWER: Indian Politics 1915–1922. By Judith M. Brown. EVERY FIFTH CHILD: The Population of China. By Leo A. Orleans. THE CHINESE YOUTH PARTY 1923–1945. By Chan Lau Kit-ching. WAGE PATTERNS AND WAGE POLICY IN MODERN CHINA 1919–1972. By Christopher Howe. THE INTERNAL POLITICS OF CHINA 1949–1972. By Jüirgen Domes. THE STRAITS SETTLEMENTS, 1826–67: Indian Presidency to Crown Colony. By C.M. Turnbull. VITI: An Account of a Government Mission to the Vitian or Fijian Islands 1860–1861. By Berthold Seemann; edited by Philip A. Snow. Colonial History Series Number 85. THE FOUNDERS OF CANTERBURY. Edited by Edward Jerningham Wakefield; and an introduction by Peter Burroughs. Colonial History Series Number 86. A VOYAGE TO AND FROM THE ISLAND OF BORNEO. By Daniel Beeckman; and an introduction by Chin Yoon Fong. Colonial History Series Number 87. CONFLICT BEHAVIOUR AND LINKAGE POLITICS. Edited by Jonathan Wilkenfeld. POLITICAL DECISION-MAKING PROCESSES: Studies in National, Comparative and International Politics. Edited by Dusan Sidjanski. THE POLITICS OF MOTION: The World of Thomas Hobbes. By T.A. Spragens jr. DEPENDENCE AND OPPORTUNITY: Political Change in Ahafo. By John Dunn and A.F. Robertson. THE PRICE OF LIBERTY: Personality and Politics in Colonial Nigeria. By Kenneth W.J. Post and George D. Jenkins. FROM RESISTANCE TO REVOLUTION: Colonial Radicals and the Development of American Opposition to Britain, 1765–1776. By Pauline Maier. ELITE ACCOMMODATION IN CANADIAN POLITICS. By Robert Presthus. THE SELECTION OF NATIONAL PARTY LEADERS IN CANADA. By John C. Courtney. THE INFLUENCE OF THE UNITED STATES ON CANADIAN DEVELOPMENT: Eleven Case Studies. Edited by Richard A. Preston. ANGLO-AMERICAN POLITICS, 1660–1765: The Relationship between Parties in England and Colonial America. By A.G. Olson. THE ECONOMICS AND POLITICS OF SOCIALISM: Collected Essays. By Wlodzimierz Brus. THE SOVIET UNION IN WORLD AFFAIRS: A Documented Analysis, 1964–1972. By W.W. Kulski. HITLERS STRATEGY 1940–41: The Balkan Clue. By Martin L. van Crefeld. HITLERS FREE CITY: A History of the Nazi Party in Danzig, 1925–39. By Herbert S. Levine. FRENCH CAPITALISM IN THE NINETEENTH CENTURY. By Guy P. Palmade. Translated with an Introduction by Graeme M. Holmes. THE POLICE AND THE PEOPLE: French Popular Protest, 1789–1820. By R.C. Cobb. TURGOT ON PROGRESS, SOCIOLOGY AND ECONOMICS. Translated, edited and with an introduction by Ronald L. Meek. LAFAYETTE IN THE FRENCH REVOLUTION: From the October Days through the Federation. By Louis Gottschalk and Margaret Maddox. THE MEN OF THE FIRST FRENCH REPUBLIC: Political alignments in the National Convention of 1792. By Alison Patrick. THE PRO-BOERS: The Anatomy of Antiwar Movement. Edited with an introduction by Stephen Koss. THE BALANCE POINT BETWEEN LOCAL AUTONOMY AND NATIONAL CONTROL. By S.E.M. Sadek. UMNAO AND THE PRICE OF LASTING PEACE. By Edgar Ansel Mowrer and Lillian T. Mower.     

A fatal case of chlorate poisoning: confirmation by ion chromatography of body fluids

A 49-year-old male chemical industry worker was admitted to intensive care with a 24-hour history of respiratory failure, vomiting, headache, stupor, arterial hypotension, and cyanosed face and limbs. He had acute haemolysis (3.9 g/L plasma haemoglobin concentration) and 30% methaemoglobinaemia. Whereas the search for alcohol, barbiturates and opiates was negative, benzodiazepines and tricyclic antidepressants were present. The patient was in fact being treated with fluvoxamine, amitryptiline, and alprazolam. As the clinical and biological signs suggested chlorate poisoning, chlorate was looked for by using an aniline color reaction. It was found in gastric content and urine. Treatment consisted in mechanical ventilation, vasoactive amines, methylene blue, plasma exchange, exchange transfusion, and haemodialysis. Despite this, the patient had several cardiac arrests and refractory metabolic acidosis. He died 12 h after his admission. Specific ion chromatography was used afterhand to assay the chlorate in various body fluids. The technique was based on a separation on an ion exchange Dionex AS 12A column coupled with conductivity detection. A quantitative estimation was carried out by using external calibration with a four-point calibration curve which was linear between 1 and 15 mg/L. The measured plasma levels of chlorate were 78 and 29 mg/L respectively before and after exchange transfusion. Gastric-lavage liquid contained 1300 mg/L of chlorate and urine 4300 mg/L. Ion chromatography, which is routinely used in environmental studies helped to confirm a massive oral intake of chlorate by measuring the corresponding blood and urine chlorate concentrations, data which had only rarely been reported previously.