Kodama K, Tamura T, Arai J
Department of Internal Medicine, Hyogo Prefectural Awaji Hospital.
Kansenshogaku Zasshi. 1998 Feb;72(2):142-6. doi: 10.11150/kansenshogakuzasshi1970.72.142.
A 25-year-old male, who had returned from the Republic of Mali in Africa, was admitted to our hospital because of a 3-day history of high fever, on the first of October 1996. He was diagnosed as Plasmodium falciparum malaria by peripheral blood smear. From the admission day he was treated with quinine HCL, 1,500 mg per day, and sulfamethoxazole 2,400 mg trimethoprim 480 mg per day, but on October 2nd blood examination showed 35% parasite density and he was given mefloquine. However he was complicated with DIC on October 3rd, ARDS on October 5th. By anti-coagulant therapy and methylprednisolone pulse therapy he became afebrile and respiratory function improved rapidly. ARDS should be emphasized as a severe complication of imported severe malaria.
一名25岁男性,于1996年10月1日因持续3天的高热被收治入院,他刚从非洲马里共和国归来。通过外周血涂片检查,他被诊断为恶性疟原虫疟疾。自入院之日起,他接受了每日1500毫克盐酸奎宁以及每日2400毫克磺胺甲恶唑和480毫克甲氧苄啶的治疗,但在10月2日的血液检查中显示寄生虫密度为35%,随后他接受了甲氟喹治疗。然而,他在10月3日出现了弥散性血管内凝血(DIC)并发症,并于10月5日出现急性呼吸窘迫综合征(ARDS)。通过抗凝治疗和甲泼尼龙冲击疗法,他退热了,呼吸功能也迅速改善。应强调ARDS是输入性重症疟疾的一种严重并发症。