From: The clinical spectrum of severe childhood malaria in Eastern Uganda
Clinical criteria | Definition |
---|---|
Clinical jaundice | Yellow mucous membranes noted in sufficient daylight |
Respiratory distress | Increased work of breathing, manifesting as deep, fast or very slow breathing, including retractions and the use of accessory muscles |
Severe anaemia | Haemoglobin < 5 g/dL |
Prostration | Generalized weakness so that the patient is unable walk or sit up without assistance |
Coma | Unrousable state with a corresponding Blantyre Coma Score (BCS) of ≤ 2 for which no other cause other than malaria could be identified |
Haemoglobinuria | History of or clinician-observed red or cola-coloured urine |
Multiple convulsions | More than two grand-mal seizures during the 24-h period preceding admission |
Spontaneous bleeding | Physically un-induced and irrepressible bleeding from at least 2 non-traumatized sites in a patient with severe malaria without previous history of abnormal bleeding |
Laboratory criteria | |
 Hyperlactataemia | Lactate > 5 mmol/L |
 Hyperparasitaemia | >5% parasitized erythrocytes or > 250 000 parasites/μL |
 Hyperpyrexia | Axillary temperature ≥ 40.0°C |
 Hypoxaemia | Oxygen saturation < 90% |
 Hypoglycaemia | Whole blood glucose concentration < 2.2 mmol/L |
 Metabolic acidosis | Plasma bicarbonate < 15 mmol/L |