Lahad Datu Hospital, Department of Medicine, Lahad Datu, Sabah, Malaysia.
Lahad Datu Hospital, Emergency Department, Lahad Datu, Sabah, Malaysia.
Med J Malaysia. 2020 Mar;75(2):171-172.
We report a rare case of severe Plasmodium knowlesi malaria and dengue co-infection in a 36-year-old lady with hyperparasitaemia, metabolic acidosis, haemolysis and acute kidney injury. She was in shock requiring inotropic support and elective intubation. She had pericardial tamponade which necessitate pericardiocentesis to allow for haemodynamic stability during haemodialysis. She underwent haemodialysis, was ventilated for six days and stayed in hospital for 29 days. She was discharged home well with almost complete renal recovery. Physicians must have a high degree of suspicion for dengue co-infection in malaria patients with plasma leakage such as pericardial effusion to allow for prompt management.
我们报告了一例罕见的严重间日疟原虫和登革热合并感染病例，患者为一名 36 岁女性，伴有高寄生虫血症、代谢性酸中毒、溶血性贫血和急性肾损伤。她发生休克，需要使用正性肌力药物支持和选择性插管。她有心包填塞，需要进行心包穿刺术，以便在血液透析期间保持血液动力学稳定。她接受了血液透析，呼吸机通气六天，住院 29 天。她出院时情况良好，肾功能几乎完全恢复。对于存在血浆渗漏（如心包积液）的疟疾患者，如间日疟原虫感染，医生必须高度怀疑合并登革热感染，以便及时进行治疗。
