Perren A, Beretta F, Schubarth P
Servizio di Cure Intense, Ospedale San Giovanni, Bellinzona.
Schweiz Med Wochenschr. 1998 Jun 20;128(25):1020-3.
Acute renal failure, disseminated intravascular coagulation, ARDS, hypoglycaemia, coma or epileptic seizures are manifestations of severe Plasmodium falciparum malaria. On the other hand, vivax malaria or benign tertian malaria is usually free from complications. In the present report we describe a case of acute tertian malaria with a severe and complicated course. In this situation bacterial coinfection should always be suspected and treated empirically with broad-spectrum antibiotics, until the results of cultures are available. Mixed plasmodial infection (P. vivax and P. falciparum) must be excluded by repeated and meticulous examination of blood smears. Newer techniques such as PCR processing or ParaSight F Test are mentioned.
急性肾衰竭、弥散性血管内凝血、急性呼吸窘迫综合征、低血糖、昏迷或癫痫发作是恶性疟原虫严重疟疾的表现。另一方面,间日疟或良性三日疟通常无并发症。在本报告中,我们描述了一例急性三日疟且病程严重并伴有并发症的病例。在这种情况下,应始终怀疑有细菌合并感染,并在获得培养结果之前,经验性地使用广谱抗生素进行治疗。必须通过反复仔细检查血涂片来排除混合疟原虫感染(间日疟原虫和恶性疟原虫)。文中提到了诸如聚合酶链反应检测或帕拉西特F检测等新技术。