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