Badiaga Sékéné, Brouqui Philippe, Carpentier Jean Pierre, Hovette Philippe, Duigou Fabien, Manelli Jean Claude, Martin Claude, Delmont Jean
Service d'Accueil des Urgences, Hôpital Nord, Marseille, France.
J Emerg Med. 2005 Nov;29(4):375-82. doi: 10.1016/j.jemermed.2005.03.009.
The objectives of this retrospective study were to describe initial clinical profiles and subsequent outcome of adult patients in France who were diagnosed with severe imported malaria, as defined by the World Health Organization (WHO). Forty-two patients diagnosed from 1996 to 2002 were included (median age: 30 years, men: 78%, non-immune persons: 74%, return from Africa: 100%, inappropriate antimalarial chemoprophylaxis: 95%). At the time of hospital admission, jaundice (62%), hyperparasitemia (56%), and prostration (52%) were the most frequent findings, followed by acute renal failure (31%). Other findings, as described by the WHO criteria, were less common. Twenty-three patients presented only with jaundice, hyperparasitemia, or prostration in isolation, or in combination. Of these 23, five non-immune persons subsequently developed coma, shock, acute respiratory distress syndrome or acute renal failure; this led to death in 2 of these cases. This suggests that non-immune persons with imported malaria who present with jaundice, hyperparasitemia, or prostration should be admitted to the intensive care unit for close monitoring.
本回顾性研究的目的是描述法国成年患者被诊断为世界卫生组织（WHO）定义的严重输入性疟疾后的初始临床特征及后续结局。纳入了1996年至2002年期间诊断的42例患者（中位年龄：30岁，男性：78%，非免疫人群：74%，来自非洲：100%，抗疟化学预防不当：95%）。入院时，黄疸（62%）、高疟原虫血症（56%）和极度衰弱（52%）是最常见的表现，其次是急性肾衰竭（31%）。按照WHO标准描述的其他表现则较少见。23例患者仅单独或合并出现黄疸、高疟原虫血症或极度衰弱。在这23例患者中，5例非免疫人群随后出现昏迷、休克、急性呼吸窘迫综合征或急性肾衰竭；其中2例死亡。这表明出现黄疸、高疟原虫血症或极度衰弱的输入性疟疾非免疫人群应入住重症监护病房进行密切监测。
