Obana M, Yamakawa H, Matsuoka Y, Kano S, Waki S, Suzuki M
Kansenshogaku Zasshi. 1989 Jan;63(1):83-8. doi: 10.11150/kansenshogakuzasshi1970.63.83.
A 39-year-old Japanese male engineer who stayed in Nigeria from August 17, 1987 through January 22, 1988, presented chloroquine-resistant Plasmodium falciparum malaria. He was taking oral chloroquine prophylactically. But he suffered from P. falciparum malaria in November, 1987 and early January, 1988. He was treated in Nigeria. After his return to Japan, he was admitted to our hospital with a fever of 39 degrees C on January 29, 1988. The peripheral blood smear on admission showed the presence of ring form P. falciparum. He was diagnosed as recrudescence of P. falciparum malaria. Laboratory examination revealed severe thrombocytopenia and biologic false-positive serological tests of syphilis. The level of 50% inhibitory concentration was 0.44 nmol/ml by in vitro chloroquine sensitivity test of the strain of P. falciparum obtained from this patient. Clinically, chloroquine was not effective. The patient was treated with intravenous quinine dihydrochloride followed by sulfadoxine/pyrimethamine tablets and recovered completely. As far as we know through our survey this patient was the first case of chloroquine-resistant P. falciparum malaria brought to Japan from Nigeria.
一名39岁的日本男性工程师于1987年8月17日至1988年1月22日期间留在尼日利亚，患了对氯喹耐药的恶性疟原虫疟疾。他一直在口服氯喹进行预防。但他在1987年11月和1988年1月初患了恶性疟原虫疟疾。他在尼日利亚接受了治疗。回到日本后，他于1988年1月29日因发烧39摄氏度入住我院。入院时外周血涂片显示有恶性疟原虫环状体。他被诊断为恶性疟原虫疟疾复发。实验室检查显示严重血小板减少和梅毒血清学生物学假阳性。通过对该患者分离出的恶性疟原虫菌株进行体外氯喹敏感性试验，50%抑制浓度水平为0.44 nmol/ml。临床上，氯喹无效。患者接受了静脉注射二盐酸奎宁治疗，随后服用了周效磺胺/乙胺嘧啶片，完全康复。据我们调查所知，该患者是第一例从尼日利亚带回日本的对氯喹耐药的恶性疟原虫疟疾病例。
