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26 岁男性患者患恶性疟伴出血性脑卒中:罕见病例报告。

Falciparum malaria with haemorrhagic stroke in a 26-year male patient: report of a rare case.

机构信息

School of Medicine, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia.

Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia.

出版信息

Malar J. 2024 Sep 28;23(1):291. doi: 10.1186/s12936-024-05022-w.

Abstract

BACKGROUND

Malaria continues to cause unacceptably high levels of disease and death despite increased global efforts and is still significant public health problem. African countries are disproportionately affected by malaria. The objective of this study was to describe a rare case of haemorrhagic stroke as a possible complication of malaria in a 26-year-old male patient.

CASE PRESENTATION

A 26-year-old male from southwest Ethiopia presented with complaint of loss of consciousness (LOC) of 12 h duration. He had fever, headache, vomiting, chills, rigors and shivering three days prior to the loss of consciousness. On physical examination, pulse rate 116 beats/min, blood pressure of 120/90 mmHg, respiratory rate was 24 breaths/min, a temperature of 38.9◦C and oxygen saturation of 94%. Nervous system examination; stuporous with Glasgow Coma Scale (GCS) 10/15(M, E, V). Blood film and RDT confirmed a Plasmodium falciparum infection and a non-contrast CT scan found a right cerebral parenchymal haemorrhage.

DISCUSSION AND CONCLUSION

The presented case described a very rare case of a 26-year-old male patient who was diagnosed with left side hemiparesis secondary to a haemorrhagic stroke, associated with P. falciparum malaria. This report highlights the fact that malaria with stroke should be considered a differential diagnosis in a patient presenting with body weakness in a malaria endemic area and in individuals who had travel history to malaria endemic areas.

摘要

背景

尽管全球加大了力度,但疟疾仍导致疾病和死亡水平居高不下,仍是一个严重的公共卫生问题。非洲国家受疟疾的影响不成比例。本研究的目的是描述一名 26 岁男性患者疟疾可能引起的出血性中风这一罕见病例。

病例介绍

一名来自埃塞俄比亚西南部的 26 岁男性,因意识丧失 12 小时就诊。他在意识丧失前三天有发热、头痛、呕吐、寒战、发抖和颤抖。体格检查时,脉搏 116 次/分,血压 120/90mmHg,呼吸频率 24 次/分,体温 38.9◦C,血氧饱和度 94%。神经系统检查:昏迷,格拉斯哥昏迷量表(GCS)评分为 10/15(M、E、V)。血片和 RDT 证实为恶性疟原虫感染,非对比 CT 扫描发现右大脑实质出血。

讨论与结论

本病例描述了一名非常罕见的 26 岁男性患者,他被诊断为左侧偏瘫,继发于出血性中风,与恶性疟原虫疟疾有关。本报告强调了这样一个事实,即在疟疾流行地区出现身体无力的患者以及有疟疾流行地区旅行史的个体中,应将疟疾伴发中风视为鉴别诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23ea/11439193/82a7aed19831/12936_2024_5022_Fig1_HTML.jpg

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