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[病例报告:两例输入性恶性疟病例]

[Case report: two imported Plasmodium falciparum cases].

作者信息

Köse Sükran, Kirakli Cenk, Ozensoy Töz Seray, Kuzucu Lütfiye, Akkoçlu Gülgün, Cevikel Nihat

机构信息

Tepecik Eğitim ve Araştirma Hastanesi, Klinik Mikrobiyoloji ve Enfeksiyon Hastaliklari, Izmir, Turkey.

出版信息

Turkiye Parazitol Derg. 2009;33(4):280-2.

Abstract

A 23 year-old Pakistani man presented at the emergency clinic of Tepecik Research and Training Hospital with the symptoms such as fever (39.3 degrees C), blurred consciousness, subicteric sclera and splenomegalia. In the laboratory examination, a slightly increase of the liver enzymes and anemia were detected. The gametocytes and trophozoites of Plasmodium falciparum were seen in a bone marrow aspiration and treatment was started with quinine and doxycycline but since resistance was detected to these medicines, mefloquine was chosen as alternative therapy. He was cured and discharged. The second case was also a Pakistani 20-year old man and he was a friend of first case. He presented at our hospital with the symptoms such as fever (39.4 degrees C), closed consciousness, icteric sclera and systolic soufflé in all cardiac foci. During the laboratory examination, severe anemia and trombocytopenia, and an increase in the liver enzymes were found. P. falciparum gametocytes and young trophozoites were seen in a blood smear stained with Giemsa. For treatment, mefloquine was used but unfortunately the patient died due to an adult respiratory distress syndrome (ARDS) complication. In this study, two cases with different clinical manifestations were presented to emphasize the importance of timing in starting the correct treatment.

摘要

一名23岁的巴基斯坦男子前往泰佩吉克研究与培训医院的急诊室就诊,症状包括发烧(39.3摄氏度)、意识模糊、巩膜轻度黄疸和脾肿大。实验室检查发现肝酶略有升高和贫血。在骨髓穿刺中发现了恶性疟原虫的配子体和滋养体,开始用奎宁和强力霉素进行治疗,但由于检测到对这些药物有耐药性,选择甲氟喹作为替代疗法。他治愈后出院。第二例也是一名20岁的巴基斯坦男子,是第一例患者的朋友。他因发烧(39.4摄氏度)、意识不清、巩膜黄疸和所有心脏听诊区出现收缩期杂音等症状前来我院就诊。实验室检查发现严重贫血和血小板减少,以及肝酶升高。在吉姆萨染色的血涂片中可见恶性疟原虫配子体和年轻滋养体。治疗使用了甲氟喹,但不幸的是,患者因成人呼吸窘迫综合征(ARDS)并发症死亡。在本研究中,介绍了两例临床表现不同的病例,以强调开始正确治疗时时机的重要性。

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