Pan Bo, Pei Fu-quan, Ruan Cai-wen, Lin Rong-xing, Cen Yong-zhen, Liu Meng-ran, Deng Zhuo-hui, Ren Wen-feng, Liao Yin-bin, Li Xiao-heng
Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi. 2016 Dec;34(6):513-6.
To diagnose and treat the first imported active case of Plasmodium knowlesi infection in China.
The clinical information of the patient was collected. Microscopy of blood smear was conducted after Giemsa staining. Genomic DNA was extracted from blood, and PCR was conducted to amplify rDNA. The PCR products were sequenced and analyzed with BLAST
The patient returned from a one-week tour in a tropical rain forest in Malaysia. The first disease attack occurred in Guangzhou on Oct. 16, 2014, with fever, shivering and sweating. The patient was initially diagnosed as malaria and hospitalized on Oct. 26, 2014. Microscopic observation revealed typical forms of P. knowlesi in blood smear. The red blood cells became enlarged, with big trophozoites appearing as a ring with dual cores and dark brown malaria pigment. The trophozoites were slightly bigger and thicker than P. falciparum. The schizont had 6-8 merozoites, with obvious brown malaria pigment. PCR resulted in a specific band of 1 099 bp. BLAST analysis showed that the sequence of the PCR product was 99% homologous to P. knowlesi (acession No. AM910985.1, L07560.1 and AY580317.1). The patient was diagnosed as P. knowlesi infection, and was then given an 8-day treatment with chloroquine and primaquine, together with dihydroartemisinin piperaquine phosphate tablet. The patient was discharged after recovery on Oct. 28, 2014.
According to the clinical symptoms, epidemiological history and laboratory test, the patient has been confirmed as P. knowlesi infection. It may also be the first active case of knowlesi malaria reported in China.
诊断并治疗中国首例输入性诺氏疟原虫感染现症病例。
收集患者临床资料。经吉姆萨染色后进行血涂片镜检。从血液中提取基因组DNA，进行PCR扩增rDNA。对PCR产物进行测序并用BLAST分析。
患者从马来西亚热带雨林为期一周的旅行归来。2014年10月16日在广州首次发病，出现发热、寒战及出汗症状。患者最初被诊断为疟疾，并于2014年10月26日住院。镜检发现血涂片中存在典型的诺氏疟原虫形态。红细胞增大，大滋养体呈双核心环状，有深褐色疟色素。滋养体比恶性疟原虫略大且厚。裂殖体有6 - 8个裂殖子，有明显的褐色疟色素。PCR扩增得到一条1 099 bp的特异性条带。BLAST分析显示，PCR产物序列与诺氏疟原虫（登录号AM910985.1、L07560.1和AY580317.1）的序列同源性为99%。患者被诊断为诺氏疟原虫感染，随后给予氯喹和伯氨喹8天治疗，并加用磷酸哌喹双氢青蒿素片。患者于2014年10月28日康复出院。
根据临床症状、流行病学史及实验室检查，确诊该患者为诺氏疟原虫感染。这可能也是中国报道的首例诺氏疟现症病例。
