Gençtürk Mehmet, Sarıca Cırık Nihal, Dalkılıç Muhammed Said, Yılmaz Merih, Erdem Hasan
Obesity Surgery, Dr. HE Obesity Clinic, Istanbul, TUR.
Microbiology, Istanbul Public Health Laboratory, Istanbul, TUR.
Cureus. 2023 Nov 29;15(11):e49683. doi: 10.7759/cureus.49683. eCollection 2023 Nov.
A 41-year-old woman from the Democratic Republic of the Congo underwent laparoscopic sleeve gastrectomy (LSG) as a surgical treatment for obesity. Despite an unremarkable preoperative evaluation, the patient developed a fever and elevated C-reactive protein (CRP) levels postoperatively. Physical examination findings, laboratory tests, and imaging studies ruled out surgical complications, leading to the consideration of infectious causes. A thorough patient history revealed a residence in a malaria-endemic region with a history of recurrent malaria episodes. In addition to her complaints, the patient developed pancytopenia. The blood smear revealed the presence of ring forms of in red blood cells, along with other species of Plasmodium. The rapid diagnostic test (RDT) showed a positive result for the antigen, a negative result for the antigen, and a positive result for the pan-antigen. Based on these findings, a mixed malaria infection was considered for the patient, and she was transferred to an advanced infectious disease hospital for specific typing and further treatment. The patient received prompt treatment and was discharged in stable condition. Malaria could potentially be among the uncommon factors leading to fever after bariatric surgery in patients from malaria-endemic countries. Surgical stress may exacerbate the course of a malaria infection.
一名来自刚果民主共和国的41岁女性接受了腹腔镜袖状胃切除术（LSG）作为肥胖症的外科治疗方法。尽管术前评估未见异常，但患者术后出现发热和C反应蛋白（CRP）水平升高。体格检查结果、实验室检查和影像学研究排除了手术并发症，于是考虑感染原因。详细的患者病史显示，她居住在疟疾流行地区，有反复疟疾发作史。除了她的主诉外，患者还出现了全血细胞减少。血液涂片显示红细胞中有环状体形式，以及其他疟原虫种类。快速诊断试验（RDT）显示 抗原检测结果为阳性， 抗原检测结果为阴性，泛抗原检测结果为阳性。基于这些发现，考虑该患者为混合性疟疾感染，她被转至一家高级传染病医院进行特定分型和进一步治疗。患者得到了及时治疗，出院时病情稳定。疟疾可能是疟疾流行国家患者减肥手术后发热的罕见因素之一。手术应激可能会加重疟疾感染的病程。
