Cheikhrouhou Fatma, Ammar Rania, Bellili Samar, Jdidi Ines, Bahloul Mabrouk, Ayadi Ali, Bouaziz Mounir
Tunis Med. 2019 Feb;97(2):379-382.
Malaria is a worldwide problem. Infection with Plasmodium. falciparum that may cause a multi-organ-failure, especially if the diagnose wasn't at time. Macrophage activation syndrome is a clinical and biological syndrome caused by an excessive proliferation of T lymphocytes. Plasmodium falciparum infection was rarely reported as a cause of this syndrome reported in the literature. We report a case of severe airport malaria in a 62-year-old man complicated by Macrophage activation syndrome. The patient was treated with intravenous quinine for 7days, catecholamine, volume expansion, mechanical ventilation, sedation and dialysis. But the evolution was marked by a multi-organ failure leading to the death of the patient. The occurrence of airport malaria stresses the need for sensitization of clinicians for considering malaria in febrile individuals even when they have not traveled to an endemic area. Clinicians should be aware of Macrophage activation syndrome when malaria does not respond to conventional therapy, since early diagnosis and prompt treatment may dramatically reduce the mortality associated with this condition.
疟疾是一个全球性问题。感染恶性疟原虫可能导致多器官功能衰竭,尤其是在诊断不及时的情况下。巨噬细胞活化综合征是一种由T淋巴细胞过度增殖引起的临床和生物学综合征。在文献中,恶性疟原虫感染很少被报道为该综合征的病因。我们报告一例62岁男性的重症机场疟疾,并发巨噬细胞活化综合征。患者接受了7天的静脉注射奎宁治疗,以及儿茶酚胺、容量扩充、机械通气、镇静和透析治疗。但病情发展以多器官功能衰竭为特征,最终导致患者死亡。机场疟疾的发生强调了临床医生提高认识的必要性,即使发热患者未前往疟疾流行地区,也应考虑疟疾的可能性。当疟疾对传统治疗无反应时,临床医生应意识到巨噬细胞活化综合征的可能,因为早期诊断和及时治疗可能显著降低与此病症相关的死亡率。