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由间日疟原虫引起的致命性疟疾呼吸并发症。

A fatal respiratory complication of malaria caused by Plasmodium vivax.

机构信息

Instituto Nacional de Infectologia Evandro Chagas Fiocruz, Rio de Janeiro, Brazil.

Centro de Pesquisa, Diagnóstico e Treinamento em Malária da Fiocruz e da Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil.

出版信息

Malar J. 2023 Oct 9;22(1):303. doi: 10.1186/s12936-023-04720-1.

Abstract

BACKGROUND

Malaria is endemic and represents an important public health issue in Brazil. Knowledge of risk factors for disease progression represents an important step in preventing and controlling malaria-related complications. Reports of severe forms of Plasmodium vivax malaria are now becoming a common place, but respiratory complications are described in less than 3% of global literature on severe vivax malaria.

CASE PRESENTATION

A severe respiratory case of imported vivax malaria in a previously healthy 40-year-old woman has been reported. The patient died after the fifth day of treatment with chloroquine and primaquine due to acute respiratory distress syndrome.

CONCLUSIONS

Respiratory symptoms started 48 h after the initiation of anti-malarial drugs, raising the hypothesis that the drugs may have been involved in the genesis of the complication. The concept that vivax malaria is a benign disease that can sometimes result in the development of serious complications must be disseminated. This report highlights, once more, the crucial importance of malaria early diagnosis, a true challenge in non-endemic areas, where health personnel are not familiar with the disease and do not consider its diagnosis promptly.

摘要

背景

疟疾在巴西流行,是一个重要的公共卫生问题。了解疾病进展的风险因素是预防和控制疟疾相关并发症的重要步骤。现在越来越多的报告提到了严重的间日疟原虫疟疾,但在全球关于严重间日疟的文献中,仅有不到 3%描述了呼吸道并发症。

病例介绍

报告了一例既往健康的 40 岁女性输入性间日疟严重呼吸道病例。该患者在接受氯喹和伯氨喹治疗 5 天后死于急性呼吸窘迫综合征。

结论

呼吸道症状在开始抗疟药物治疗后 48 小时出现,这提示药物可能参与了并发症的发生。间日疟原虫是一种良性疾病,但有时会导致严重并发症,这一概念必须得到传播。本报告再次强调了疟疾早期诊断的至关重要性,这在非流行地区是一个真正的挑战,因为那里的卫生人员不熟悉这种疾病,也不能及时诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d239/10563287/d723ece9f739/12936_2023_4720_Fig1_HTML.jpg

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