山东省首例输入性三日疟病例报告

The first report of a case of imported quartan malaria in Shandong Province

本文报告山东省首例输入性三日疟,患者曾在非洲安哥拉务工4年,回国后2d(2013年1月25日)因发热、出汗、头痛、乏力而就诊,疟原虫血涂片镜检阴性。50d后(2013年3月17日)再次因发热、全身乏力就诊,血涂片镜检发现疟原虫,诊断为间日疟,经氯喹/伯氨喹8d治疗后痊愈,随访3个月未见再燃。省级复核血涂片发现典型的三日疟多期原虫,经PCR基因检测,确证为三日疟。提示应加强疟防专业人员诊治罕见三日疟、卵形疟的技能培训,以减少误诊、误治。

Reported here is the first case of imported quartan malaria in Shandong Province. The patient in question had worked in Angola for four years. Two days after returning to China （January 25, 2013）, the patient was seen for a fever, sweating, headaches, and fatigue. Microscopy indicated that blood smears were negative for Plasmodium parasites. Fifty days later （March 17, 2013）, the patient was seen again for a fever and malaise. Microscopy of blood smears revealed Plasmodium parasites, and the patient was diagnosed with tertian malaria. The patient recovered 8 days after treatment with chloroquine/primaquine. The patient was followed for 3 months but malaria did not reappear. A review of blood smears at the provincial level found classic malaria parasites in multiple stages. Genetic testing with PCR indicated that the malaria was in fact quartan malaria. Skills training for malaria prevention personnel to diagnose and treat rare cases of quartan malaria and ovale malaria should be enhanced in order to reduce incidences of misdiagnosis.