Sağmak Tartar Ayşe, Akbulut Ayhan, Gökmen Sevindik Ömür, Akbulut Hatice Handan, Demirdağ Kutbeddin
Fırat Üniversitesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Elazığ, Türkiye.
Fırat Üniversitesi, Hematoloji Bilim Dalı, Elazığ, Türkiye.
Turkiye Parazitol Derg. 2017 Dec;41(4):219-222. doi: 10.5152/tpd.2017.5584.
In our country, within years, despite a dramatic drop in the number of patients with malaria, a dramatic increase in the number of patients with import malaria is noteworthy. A 32-year-old male patient presented with fever, shivering, malaise, and loss of appetite. He had travelled to West Africa. Laboratory findings were as follows: hemoglobin: 8.8 g/dL and anti-HIV: positive. Microscopic examinations of thin blood smears and thick blood preparations revealed widespread trophozoites. The presence of double-dotted ring forms and banana-shaped gametocytes resulted in Plasmodium falciparum malaria being diagnosed. The patient was started treatment with oral artemether 20 mg/ lumefantrine 120 mg 2×4 tablets and trimethoprim-sulfamethoxazole. During his follow-up, hemoglobin levels regressed to 5.8 g/dL. The patient was diagnosed as having severe malaria. He visited our hematology unit, and exchange transfusion (EET) was recommended. Using an EET apheresis device, eight units of erythrocyte suspension was transfused. The cured patient was discharged. This case was found to be interesting and reminds us the possible presence of comorbid conditions associated with malaria in patients who have a history of travelling abroad. Although its effectiveness has not been proved thus far, as a striking result, EET was used as an alternative treatment in a patient with severe malaria.
在我国，数年来，尽管疟疾患者数量急剧下降，但输入性疟疾患者数量的显著增加值得关注。一名32岁男性患者出现发热、寒战、不适和食欲不振。他曾前往西非。实验室检查结果如下：血红蛋白：8.8 g/dL，抗HIV：阳性。薄血涂片和厚血涂片的显微镜检查发现广泛存在滋养体。双点环状体和香蕉形配子体的存在导致诊断为恶性疟原虫疟疾。患者开始接受口服蒿甲醚20 mg/本芴醇120 mg 2×4片及甲氧苄啶-磺胺甲恶唑治疗。在随访期间，血红蛋白水平降至5.8 g/dL。该患者被诊断为重症疟疾。他前来我们的血液科就诊，建议进行换血治疗（EET）。使用EET血液分离设备，输注了8单位红细胞悬液。治愈后患者出院。该病例很有趣，提醒我们有出国旅行史的疟疾患者可能存在与疟疾相关的合并症。尽管目前尚未证明其有效性，但作为一个显著的结果，EET被用作一名重症疟疾患者的替代治疗方法。
