儿童川崎病合并间日疟原虫和恶性疟原虫混合感染：一个临床难题。

MIS-C and co-infection with P. vivax and P. falciparum in a child: a clinical conundrum.

机构信息

Division of Paediatric Infectious Diseases, "G. Di Cristina" Hospital, ARNAS Civico, Palermo, Italy.

Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.

出版信息

Ital J Pediatr. 2022 Jul 27;48(1):130. doi: 10.1186/s13052-022-01311-9.

DOI:10.1186/s13052-022-01311-9

PMID:35897103

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9327400/

Abstract

BACKGROUND

The ongoing Coronavirus Disease 2019 (COVID-19) epidemic represents an unprecedented global health challenge. Many COVID-19 symptoms are similar to symptoms that can occur in other infections. Malaria should always be considered in patients with SARS-CoV-2 infection returning from endemic areas.

CASE PRESENTATION

We present the first case of multisystem inflammatory syndrome (MIS-C) and Plasmodium vivax-falciparum and SARS-CoV2 coinfection in children. Despite clearance of parassitaemia and a negative COVID-19 nasopharyngeal PCR, the patient's clinical conditions worsened. The World Health Organization (WHO) criteria were used to make the diagnosis of MIS-C. Treatment with intravenous immunoglobulins and methylprednisolone was effective.

CONCLUSIONS

This case emphasizes the importance of considering malaria diagnosis in patients returning from endemic areas, even in the COVID 19 era. Malaria and SARS-CoV2 co-infection may increase the risk of MIS-C, for which early detection is critical for proper management.

摘要

背景

正在发生的 2019 年冠状病毒病（COVID-19）疫情代表了前所未有的全球健康挑战。许多 COVID-19 症状与其他感染中可能出现的症状相似。从流行地区返回的 SARS-CoV-2 感染患者，应始终考虑疟疾的可能性。

病例介绍

我们报告了首例儿童多系统炎症综合征（MIS-C）与间日疟原虫-恶性疟原虫和 SARS-CoV2 合并感染的病例。尽管寄生虫血症已清除，且 COVID-19 鼻咽 PCR 为阴性，但患者的临床状况仍恶化。采用世界卫生组织（WHO）标准作出 MIS-C 的诊断。静脉注射免疫球蛋白和甲基强的松龙治疗有效。