Kean B H, Reilly P C
Am J Med. 1976 Aug;61(2):159-64. doi: 10.1016/0002-9343(76)90164-9.
Clinical data on 24 civilian patients hospitalized for malaria in The New York Hospital were analyzed. Of 16 patients infected with Plasmodium falciparum, 14 acquired the disease in West Africa. Only three of the 24 had taken recommended courses of prophylaxis. Diagnosis was invariably, and often dangerously, delayed because physicians often made diagnoses of viral syndromes or used antibiotics; only one patient had a blood smear taken by a personal physician. Although all patients had fever and chills, classic malarial fever was seen in only seven patients; nausea, vomiting and diarrhea were common. Hepatomegaly and splenomegaly occurred in about half the patients. Blood smears stained in routine fashion by Wright's stain were positive in 23 of 24 patients. A normal leukocyte count was present in 19 of the 24 patients and thrombocytopenia in 16 of 23. The most frequent complications were those of central nervous system involvement. Therapy consisted mainly of chloroquine phosphate but other drugs, including quinine, pyrimethamine, sulfonamides and primaquine, were used in special situations. Suggestions for prophylaxis, diagnosis and therapy were made.
对纽约医院收治的24例因疟疾住院的平民患者的临床数据进行了分析。在16例感染恶性疟原虫的患者中，有14例在西非感染了这种疾病。24例患者中只有3例接受了推荐的预防疗程。诊断总是被延误，而且常常很危险，因为医生常常将其诊断为病毒综合征或使用抗生素；只有一名患者由私人医生进行了血涂片检查。尽管所有患者都有发热和寒战，但只有7例出现了典型的疟疾热；恶心、呕吐和腹泻很常见。约一半的患者出现肝肿大和脾肿大。用瑞氏染色法进行常规染色的血涂片在24例患者中有23例呈阳性。24例患者中有19例白细胞计数正常，23例中有16例血小板减少。最常见的并发症是中枢神经系统受累。治疗主要使用磷酸氯喹，但在特殊情况下也使用了其他药物，包括奎宁、乙胺嘧啶、磺胺类药物和伯氨喹。文中提出了预防、诊断和治疗的建议。
