Inoue Juliana, Machado Clarisse Martins, Lima Giselle Fernandes Maciel de Castro, Nascimento Maria de Jesus Costa, Colturato Vergílio Rensi, Di Santi Silvia Maria
Malaria Research Center, Superintendence of Endemic Diseases Control, Health Secretariat of Sao Paulo State, Sao Paulo, SP, Brazil.
Rev Inst Med Trop Sao Paulo. 2010 Sep-Oct;52(5):281-4. doi: 10.1590/s0036-46652010000500012.
Malaria is an unusual complication after hematopoietic stem cell transplantation in non-endemic countries. However, transplant candidates, recipients and donors living in endemic regions frequently report previous episodes of malaria. This fact could represent an important risk for immunosuppressed recipients that could develop severe malaria cases. We report a case of hematopoietic stem cell transplant (HSCT) in which the donor had a history of previous malaria, and close monitoring was performed before and after procedure by parasitological and molecular tests. The donor presented Plasmodium vivax in thick blood smears one month after transplant and was treated according to Brazilian Health Ministry guidelines. The polymerase chain reaction (PCR) was able to detect malaria infection in the donor one week earlier than thick blood film. Even without positive results, the recipient was pre-emptively treated with chloroquine in order to prevent the disease. We highlight the importance of monitoring recipients and donors in transplant procedures with the aim of reducing the risk of malaria transmission.
在非疟疾流行国家,疟疾是造血干细胞移植后一种不常见的并发症。然而,生活在疟疾流行地区的移植候选者、受者和供者经常报告有既往疟疾发作史。这一情况对于可能发生严重疟疾病例的免疫抑制受者来说可能是一个重要风险。我们报告了一例造血干细胞移植(HSCT)病例,供者有既往疟疾史,在移植前后通过寄生虫学和分子检测进行了密切监测。移植后一个月,供者在厚血涂片检查中发现间日疟原虫,并按照巴西卫生部的指南进行了治疗。聚合酶链反应(PCR)比厚血膜检查能提前一周检测到供者的疟疾感染。即使没有阳性结果,受者也接受了氯喹的预防性治疗以预防疾病。我们强调在移植过程中监测受者和供者对于降低疟疾传播风险的重要性。