Palma Dos Reis Inês, Serafim Catarina, Valério Bernardino, Araújo Robson, Silvestre Joana, Mendes Vítor, Tapadinhas Camila, Gonçalves Pereira João, Póvoa Pedro
Serviço de Medicina 4.Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.
Acta Med Port. 2012 Sep-Oct;25(5):271-6. Epub 2012 Nov 12.
Imported malaria is a frequent diagnosis in Portugal, and in the most severe clinical forms it may present a high mortality rate.
We present seven cases of severe imported malaria, admitted to an intensive care unit between 2000 and 2010, with particular focus on risk factors, clinical presentation, treatment and results.
All patients had a history of recent travel to African endemic areas for malaria. Plasmodium falciparum was the agent isolated in all cases. Most patients had an inadequate prophylaxis. High parasitaemia in non-immune patients and treatment delay were associated with more severe clinical presentation. All the cases were complicated by organ failure, and three patients needed organ support and in two exchange blood transfusions were performed. There was one single death that was associated with marked delay in the initiation of therapy.
In these patients, early and aggressive treatment, with a organ support in a critical care setting, allowed a good outcome with low mortality and no significant sequelae, despite the severity of presentation.
输入性疟疾在葡萄牙是一种常见的诊断疾病，在最严重的临床形式中，其死亡率可能很高。
我们呈现了2000年至2010年间入住重症监护病房的7例严重输入性疟疾病例，特别关注危险因素、临床表现、治疗及结果。
所有患者近期均有前往非洲疟疾流行地区的旅行史。所有病例均分离出恶性疟原虫。大多数患者预防措施不当。非免疫患者的高疟原虫血症和治疗延迟与更严重的临床表现相关。所有病例均并发器官衰竭，3例患者需要器官支持，2例进行了换血输血。有1例死亡与治疗开始明显延迟有关。
在这些患者中，尽管临床表现严重，但在重症监护环境下进行早期积极治疗并给予器官支持，可取得良好预后，死亡率低且无明显后遗症。
