Teaching and Research Unit of Infectious and Tropical Diseases, Faculty of Medicine, University of Parakou, 03 P. O Box 112, Parakou, Republic of Benin.
Laboratory of Expertise and Research in Tropical Infectiology, University of Parakou, 03 P. O Box 112, Parakou, Republic of Benin.
BMC Infect Dis. 2018 Dec 17;18(1):667. doi: 10.1186/s12879-018-3587-6.
Lassa fever is one of the most lethal neglected tropical diseases in West Africa. It is a serious public health problem in this region of Africa where it is endemic in several countries. However, it remains a very little known disease by healthcare workers. The lack of specificity of its clinical manifestations makes its diagnosis difficult even in an epidemic context.
We report here a confirmed case of Lassa fever whose diagnosis could not be suspected until 11 days after the symptomatology began. This case was recognized as a suspected case of Lassa fever in the Internal Medicine Department of the Regional and Teaching Hospital of Borgou due to the persistence of the fever and the worsening of the patient's clinical condition despite triple antibiotic therapy in general and especially due to the appearance of hemorrhages. Confirmation of the presence of Lassa fever virus by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) assay on blood sample was obtained after his death despite late initiation of Ribavirin treatment.
This case challenges Benin's health authorities on the need to facilitate access to diagnosis of viral hemorrhagic fevers and to train caregivers at all levels of the health system for better management of these diseases.
拉沙热是西非最致命的被忽视热带病之一。在非洲这一地区，该病在多个国家流行，是一个严重的公共卫生问题。然而，医护人员对该病的了解仍然非常有限。其临床表现缺乏特异性，即使在流行情况下，诊断也很困难。
我们在此报告了一例确诊的拉沙热病例，直到症状出现 11 天后才怀疑该病的诊断。由于发热持续存在，且尽管采用了一般的三联抗生素治疗，患者的临床状况仍在恶化，特别是出现了出血，因此博尔古地区和教学医院内科将该病例确认为疑似拉沙热病例。尽管在发病后较晚才开始使用利巴韦林治疗，但在患者死亡后，通过对血液样本进行逆转录聚合酶链反应（RT-PCR）检测，证实存在拉沙热病毒。
该病例对贝宁卫生当局提出了挑战，需要为病毒出血热的诊断提供便利，并对各级卫生系统的医护人员进行培训，以更好地管理这些疾病。
