De Canale Ettore, Sgarabotto Dino, Marini Giulia, Menegotto Nicola, Masiero Serena, Akkouche Wassim, Biasolo Maria Angela, Barzon Luisa, Palù Giorgio
Microbiology and Virology Unit, Padova University Hospital, Padua, Italy.
Tropical and Infectious Diseases Unit, Padova University Hospital, Padua, Italy.
New Microbiol. 2017 Oct;40(4):291-294. Epub 2017 Jul 4.
Plasmodium knowlesi is a simian parasite responsible for most human cases of malaria in Malaysian Borneo. A timely recognition of infection is crucial because of the risk of severe disease due to the rapid increase in parasitemia. We report a case of P. knowlesi infection in a traveller who developed fever and thrombocytopenia after returning from the Philippines in 2016. Rapid antigen test was negative, microscopy examination showed parasites similar to Plasmodium malariae, with a parasite count of 10,000 parasites per μL blood, while molecular testing identified P. knowlesi infection. Treatment with atovaquone-proguanil led to resolution of fever and restoration of platelet count in two days. P. knowlesi infection should be suspected in febrile travellers returning from South East Asia. Due to the low sensitivity of rapid antigen tests and the low specificity of microscopy, confirmation by molecular tests is recommended.
诺氏疟原虫是一种猿类寄生虫，在马来西亚婆罗洲导致了大多数人类疟疾病例。由于寄生虫血症迅速增加会带来严重疾病风险，及时识别感染至关重要。我们报告一例诺氏疟原虫感染病例，该旅行者于2016年从菲律宾返回后出现发热和血小板减少。快速抗原检测呈阴性，显微镜检查显示寄生虫类似于三日疟原虫，每微升血液中的寄生虫计数为10000个，而分子检测确定为诺氏疟原虫感染。使用阿托伐醌-氯胍治疗两天后发热消退，血小板计数恢复。从东南亚返回的发热旅行者应怀疑感染诺氏疟原虫。由于快速抗原检测灵敏度低且显微镜检查特异性低，建议通过分子检测进行确诊。
