Division of Pediatric Infectious Diseases, The Hospital for Sick Children, Toronto, Canada.
Department of Pediatrics, Temerty Faculty of Medicine, The University of Toronto, Toronto, Canada.
Am J Trop Med Hyg. 2023 Jul 24;109(3):611-615. doi: 10.4269/ajtmh.22-0550. Print 2023 Sep 6.
A 10-year-old boy with sickle cell disease (SCD) type SC presented with fever and abdominal pain after travel to Ghana and was diagnosed with Plasmodium falciparum infection. Despite adequate antimalarial treatment, he developed evidence of hyperinflammation with marked elevated ferritin, C-reactive protein, and triglycerides and subsequent bone marrow necrosis, characterized by elevated nucleated red blood cells and significant bone pain. This case report highlights the possible association between malaria and bone marrow necrosis in patients with SCD. Important considerations in treatment and workup of patients presenting with malaria and hyperinflammation are discussed.
一名 10 岁患有镰状细胞病（SCD）SC 型的男孩在前往加纳旅行后出现发热和腹痛，并被诊断为恶性疟原虫感染。尽管进行了充分的抗疟治疗，但他仍出现了炎症过度活跃的迹象，表现为铁蛋白、C 反应蛋白和甘油三酯明显升高，随后发生骨髓坏死，表现为有核红细胞升高和明显的骨痛。本病例报告强调了疟疾和 SCD 患者骨髓坏死之间可能存在的关联。讨论了治疗和检查患有疟疾和炎症过度活跃的患者时的重要考虑因素。
