Bhardwaj Anand Kumar, Sharma P D, Sharma Akshay
Department of Paediatrics, MM Institute of Medical Sciences and Research, Ambala, India.
BMJ Case Rep. 2011 Mar 10;2011:bcr0120113742. doi: 10.1136/bcr.01.2011.3742.
The incidence of falciparum malaria is very high in India. Falciparum malaria is a multiorgan disease which can present with extremely varied presentations. The severity of the disease and difficulty in its diagnosis require a keen sense of suspicion on the part of the treating physician to diagnose it. Here is an unusual case of falciparum malaria presenting as acute appendicitis. This case did not respond to artemether therapy and that also points towards drug resistance emerging in malaria. The child was operated upon and appendix was found to be inflamed. After a tumultuous postoperative course with symptoms suggestive of acute renal failure, a diagnosis of falciparum malaria was made and quinine started. Recovery was uneventful thereafter.
恶性疟在印度的发病率非常高。恶性疟是一种多器官疾病，其临床表现极为多样。该疾病的严重性及其诊断难度要求治疗医生保持高度的怀疑意识以进行诊断。以下是一例表现为急性阑尾炎的不寻常恶性疟病例。该病例对蒿甲醚治疗无反应，这也表明疟疾出现了耐药性。患儿接受了手术，发现阑尾发炎。术后经历了一段波折的病程，出现提示急性肾衰竭的症状，之后确诊为恶性疟并开始使用奎宁治疗。此后患儿顺利康复。
