Rasheed Abdul, Saeed Shahzad, Khan Saleem Ahmed
Department of Medicine, CMH Quetta.
J Pak Med Assoc. 2009 Apr;59(4):220-3.
To find out clinical and laboratory findings in acute malaria caused by various plasmodium species.
This study was conducted in Department of Medicine and Pathology, Combined Military Hospital, Quetta, Balochistan, from August 2006 to December 2006. Five hundred and two subjects with positive malarial parasite slide were included in the study. Frequencies of alterations in clinical and laboratory parameters were determined in various plasmodium species and reported in percentage.
Of 502 patients, 311 were Plasmodium (P.) falciparum, 100 were P. vivax and 91 were mixed infection. Triad of fever, chills and sweating was present in 91% of subjects with all three varieties of P. infection. Splenomegaly was detected in 59-73% individuals with malaria. Thrombocytopenia was the leading haematological alteration associated with various P. species, seen in almost 80% of infected patients. Anaemia and Jaundice were more common in P. falciparum and mixed infection as compared to P. vivax. Serum urea, creatinine and plasma glucose were within normal limits in all the patients with malaria.
Malaria must be considered as a leading differential diagnosis in an acutely febrile patient with one or more of abnormalities like splenomegaly, fall in blood counts or rise in bilirubin and serum alanine aminotransferase levels.
了解由不同疟原虫种类引起的急性疟疾的临床和实验室检查结果。
本研究于2006年8月至2006年12月在俾路支省奎达联合军事医院的内科和病理科进行。纳入502名疟原虫涂片阳性的受试者。确定了不同疟原虫种类临床和实验室参数改变的频率,并以百分比报告。
502例患者中,311例为恶性疟原虫,100例为间日疟原虫,91例为混合感染。在所有三种疟原虫感染的受试者中,91%出现发热、寒战和出汗三联征。59%至73%的疟疾患者检测到脾肿大。血小板减少是与各种疟原虫种类相关的主要血液学改变,几乎80%的感染患者出现。与间日疟原虫相比,贫血和黄疸在恶性疟原虫和混合感染中更常见。所有疟疾患者的血清尿素、肌酐和血糖均在正常范围内。
对于出现脾肿大、血细胞计数下降或胆红素及血清丙氨酸氨基转移酶水平升高等一项或多项异常的急性发热患者,必须将疟疾视为主要的鉴别诊断疾病。