Costa Anielle de Pina, Bressan Clarisse da Silveira, Pedro Renata Saraiva, Valls-de-Souza Rogério, Silva Sidnei da, Souza Patrícia Rosana de, Guaraldo Lusiele, Ferreira-da-Cruz Maria de Fátima, Daniel-Ribeiro Cláudio Tadeu, Brasil Patrícia
Serviço de Doenças Febris Agudas, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ.
Rev Soc Bras Med Trop. 2010 Sep-Oct;43(5):571-4. doi: 10.1590/s0037-86822010000500020.
The mortality of malaria in the extra-Amazon region is about 80 times higher than in the Amazon region, where malaria is concentrated (99.8% of cases). In areas of dengue transmission, delay in the diagnosis and treatment of malaria in patients with fever who reside in areas of malaria transmission can be due to the confusion between the clinical diagnoses of both diseases by nonspecialist doctors, among other factors. This work presents some of the consequences of delayed diagnosis in three patients with malaria by Plasmodium falciparum, P. malariae and P. vivax, who, after following the usual route for Dengue treatment, sought our institution, where they were correctly diagnosed and adequately treated.
Description of three cases of malaria with delayed diagnosed malaria referred to the Outpatient Clinic for Acute Febrile Diseases, IPEC/FIOCRUZ-RJ, between 2007 and 2008.
A Brazilian from Mozambique, primo-infected with P. falciparum was diagnosed with malaria six days after the onset of fever and died of cerebral malaria and shock. Another patient with P.malariae malaria presented a severe and prolonged course, but was cured after specific treatment. A third patient, with delayed diagnosis of P. vivax malaria, acquired it in the Atlantic Forest region in the State of Rio.
Health professionals from non-endemic areas for malaria should be trained to optimize the surveillance and early treatment of malaria and prevent morbid and fatal outcomes. An investigation of outbreaks of autochthonous malaria in the State of Rio de Janeiro is suggested.
亚马逊地区以外的疟疾死亡率比疟疾集中的亚马逊地区（占病例的99.8%）高出约80倍。在登革热传播地区，居住在疟疾传播地区的发热患者中，疟疾诊断和治疗的延迟可能是由于非专科医生对这两种疾病临床诊断的混淆等因素造成的。本文介绍了三例由恶性疟原虫、三日疟原虫和间日疟原虫引起的疟疾患者诊断延迟的一些后果，这些患者在遵循常规登革热治疗途径后，前来我们机构就诊，在这里他们得到了正确诊断和充分治疗。
描述2007年至2008年间转诊至IPEC/FIOCRUZ-RJ急性发热疾病门诊的三例疟疾诊断延迟的病例。
一名来自莫桑比克的巴西人，初次感染恶性疟原虫，发热六天后被诊断为疟疾，死于脑型疟疾和休克。另一例三日疟原虫疟疾患者病程严重且持续时间长，但经特异性治疗后治愈。第三例患者间日疟原虫疟疾诊断延迟，在里约州的大西洋森林地区感染。
应培训来自非疟疾流行地区的卫生专业人员，以优化疟疾监测和早期治疗，预防发病和致命后果。建议对里约热内卢州本土疟疾疫情进行调查。
