Botella de Maglia J, Valls Ferrer J M, Martínez Paz M L, Espacio Casanovas A
Unidad de Medicina Intensiva, Hospital La Fe, Valencia.
An Med Interna. 1991 Feb;8(2):79-81.
In 1983, the first African cases of malaria due to Plasmodium falciparum resistant to sulfadoxine/pyrimethamine, were described. Currently, this resistance is frequently found in Kenya and Tanzania. It has also been described in other African countries. A young Spanish woman contracted Plasmodium falciparum malaria in Senegal and was treated in our hospital with sulfadoxine/pyrimethamine. Fever and symptoms disappear within two days. The thick smears taken on the eighth and thirteenth days of treatment contained an abundance of gametocytes, but neither trophozoites nor schizonts. As the risk of transmission of malaria to the rest of the community was considered practically nil, no other treatment was administered. A month late, she was admitted to the hospital due to fever, shivering, fatigue, loss of appetite and hemolytic anaemia. The thick smear test again showed trophozoites of P. Falciparum. Thus, it proved to be a delayed grade I resistance to sulfadoxine/pyrimethamine, detected in far west Africa. An oral dose of mefloquine was administered as well as a red cell transfusion. Both fever and symptoms finally disappeared.
1983年,首次报道了非洲出现对磺胺多辛/乙胺嘧啶耐药的恶性疟原虫导致的疟疾病例。目前,这种耐药性在肯尼亚和坦桑尼亚很常见,在其他非洲国家也有报道。一名年轻的西班牙女性在塞内加尔感染了恶性疟原虫疟疾,并在我们医院接受了磺胺多辛/乙胺嘧啶治疗。发热和症状在两天内消失。治疗第8天和第13天采集的厚血涂片中有大量配子体,但没有滋养体和裂殖体。由于认为疟疾传播给社区其他成员的风险几乎为零,所以没有进行其他治疗。一个月后,她因发热、寒战、疲劳、食欲不振和溶血性贫血入院。厚血涂片检查再次显示有恶性疟原虫滋养体。因此,这被证明是在非洲最西部检测到的对磺胺多辛/乙胺嘧啶的I级延迟耐药。给予了口服甲氟喹并进行了红细胞输血。发热和症状最终都消失了。