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先天性疟原虫感染(由恶性疟原虫引起)。

Congenital malaria by Plasmodium falciparum.

机构信息

Hospital Infantil Los Ángeles, Colombia.

Universidad Libre Cali, Colombia.

出版信息

Rev Chil Pediatr. 2020 Oct;91(5):749-753. doi: 10.32641/rchped.vi91i5.1283.

Abstract

UNLABELLED

Introdution: Congenital malaria (CM) is a Plasmodium spp infection acquired in utero or during delivery with nonspecific clinical manifestations. Plasmodium falciparum can cause severe illness in pregnant wo men and newborns.

OBJECTIVE

to describe two cases of CM caused by Plasmodium falciparum, di fferential diagnosis of sepsis in newborns of pregnant women who live in or have visited endemic malaria zones.

CLINICAL CASES

Female neonates born in a non-endemic malaria area, diagnosed with neonatal sepsis and treated with antibiotics without clinical response. After the first week of life, the peripheral blood smear identified trophozoites of Plasmodium falciparum thus the newborns were treated with intravenous quinine, improving their condition. The mothers of the two newborns who had malaria in pregnancy, one of them received treatment and she was asymptomatic, and the other one had severe malaria at the time of delivery.

CONCLUSIONS

CM can cause severe neonatal disease with non-specific, sepsis-like clinical manifestations in which early treatment decreases the risk of complicated malaria. It is a differential diagnosis in newborns of women with a history of malaria during pregnancy or pregnant women visiting or living in endemic malaria areas.

摘要

背景

先天性疟疾(CM)是一种在子宫内或分娩过程中由疟原虫属感染引起的疾病,具有非特异性临床表现。疟原虫恶性疟原虫可导致孕妇和新生儿罹患严重疾病。

目的

描述由恶性疟原虫引起的两例先天性疟疾病例,以鉴别诊断居住或曾前往疟疾流行地区的孕妇所生新生儿的败血症。

临床病例

两名女性新生儿均出生于非疟疾流行地区,被诊断为新生儿败血症,并接受抗生素治疗但无临床反应。出生后第一周,外周血涂片发现恶性疟原虫滋养体,随后新生儿接受静脉注射奎宁治疗,病情得到改善。两名新生儿的母亲均患有妊娠期疟疾,其中一名母亲接受了治疗且无症状,另一名母亲在分娩时患有严重疟疾。

结论

CM 可引起无特异性、类似败血症的严重新生儿疾病,早期治疗可降低罹患复杂疟疾的风险。CM 是曾患有疟疾或居住或前往疟疾流行地区的孕妇所生新生儿的鉴别诊断之一。

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