Smereck Janet
Department of Emergency Medicine, Georgetown University Hospital, Washington, DC 20007, USA.
J Emerg Med. 2011 Apr;40(4):393-6. doi: 10.1016/j.jemermed.2010.04.029. Epub 2010 Jun 20.
Pregnancy complicates the diagnosis, treatment, and clinical course of malaria. This clinical problem may be encountered in emergency department patients due to international travel.
A primigravida woman at 20 weeks gestation presented to the Emergency Department with episodic fever, chills, headache, and nausea after travel to India and Asia. She had not taken malaria prophylaxis. After hospitalization, she developed acute respiratory distress syndrome and required intensive care management. Although she ultimately recovered from severe infection with Plasmodium vivax, she was not able to sustain her pregnancy and suffered a miscarriage.
This case illustrates the serious nature of malaria in the pregnant patient. For this high-risk group, there is an increased incidence of severe anemia, as well as acute respiratory distress syndrome and pulmonary edema. A guideline is presented for the initial choice of anti-malarial drug treatment for the pregnant patient.
妊娠会使疟疾的诊断、治疗及临床病程变得复杂。由于国际旅行，急诊科患者可能会遇到这一临床问题。
一名妊娠20周的初产妇在前往印度和亚洲旅行后，因间歇性发热、寒战、头痛和恶心前往急诊科就诊。她未采取疟疾预防措施。住院后，她发展为急性呼吸窘迫综合征，需要重症监护管理。尽管她最终从间日疟原虫严重感染中康复，但未能维持妊娠，发生了流产。
该病例说明了妊娠患者疟疾的严重性。对于这一高危人群，严重贫血、急性呼吸窘迫综合征和肺水肿的发病率增加。本文给出了针对妊娠患者抗疟药物治疗初始选择的指南。
