Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: Dr Rossi raises a question about the potential influence of salicylate toxicity and Reye syndrome on our estimate of the burden of neurological involvement in children with falciparum malaria. He notes that administration of salicylates to febrile African children is a common practice; exposure to salicylates can predispose to Reye syndrome; metabolic acidosis, respiratory distress, coma, and hypoglycemia are clinical features that are common to salicylate toxicity and Reye syndome as well as cerebral malaria; and suggests that it is therefore necessary to measure salicylate levels in all children with clinical features of cerebral malaria and history of salicylate use to avoid a misdiagnosis between these conditions.
Idro R, Crawley J, Marsh K, Newton CRJC, Neville BGR. Neurological Involvement in Acute Falciparum Malaria in Kenyan Children—Reply. JAMA. 2007;298(11):1274. doi:10.1001/jama.298.11.1274-b