戊型肝炎病毒与恶性疟原虫合并感染：撒哈拉以南非洲的真实风险。
Co-infection of hepatitis E virus and Plasmodium falciparum malaria: A genuine risk in sub-Saharan Africa.
机构信息
Staten Island University Hospital, Staten Island, NY, 10305, USA.
Department of Internal Medicine, Hofstra School of Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY, 10305, USA.
出版信息
Parasit Vectors. 2021 Apr 20;14(1):215. doi: 10.1186/s13071-021-04723-4.
BACKGROUND
There is a high prevalence of malaria and viral hepatitis in South Africa. Co-infection with Plasmodium malaria (leading to cerebral malaria) and hepatitis E virus (HEV) is a rare phenomenon.
CASE PRESENTATION
A 33-year-old African American male with no past medical history developed altered mental status on his return from Ivory Coast. His blood tests were significant for renal and liver failure and a high Plasmodium parasite burden of 33% on the blood smear. Interestingly, he also had a positive result for hepatitis E IgM. The patient was effectively treated with aggressive hydration and intravenous (IV) artesunate.
CONCLUSION
Our report is the first to our knowledge in the cerebral malaria literature on a patient with hepatitis E co-infection. This exciting case emphasizes the importance of considering all kinds of endemic infectious diseases when evaluating sick returning travelers presenting to the emergency department.
背景
南非疟疾和病毒性肝炎的发病率很高。疟原虫（导致脑型疟疾）和戊型肝炎病毒（HEV）的合并感染较为罕见。
病例介绍
一名 33 岁的非裔美国男性，无既往病史，从象牙海岸返回后出现精神状态改变。他的血液检查显示肾功能和肝功能衰竭，血液涂片上疟原虫寄生虫负荷率高达 33%。有趣的是，他的戊型肝炎 IgM 检测结果也呈阳性。患者经积极补液和静脉注射青蒿琥酯治疗后病情得到有效控制。
结论
据我们所知，这是脑型疟疾文献中首例关于戊型肝炎合并感染的病例。这个令人兴奋的病例强调了在评估因生病返回并前往急诊科就诊的旅行者时，需要考虑所有地方性传染病的重要性。
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