骨髓涂片检查诊断输入性恶性疟疾临床及血液学分析

Bone marrow smear examination in the diagnosis of imported falciparum malaria and clinical hematology analysis

目的为了防止输入性恶性疟的误诊及漏诊,提高诊疗水平,特对输入性恶性疟的特点作一分析。方法回顾性分析该院2013年收治的2例输入性恶性疟疾患者的临床及血象和骨髓象特征。结果 2例均为从非洲回国人员,回国时无不适,出现发热后当地医院仅以抗病毒及退热治疗。至该院诊治时均不发热,外周血两系血细胞减少,骨髓象增生活跃至明显活跃,幼红细胞明显增生,于外周血及骨髓象查到恶性疟原虫。结论从非洲等疟疾疫区回来的人员,如出现发热,应首先考虑输入性疟疾,应做外周血涂片,必要时做骨髓涂片查找疟原虫,有利于疾病的诊断及鉴别诊断。

Objective To prevent misdiagnosis and missed diagnosis of imported malaria,enhance the accuracy of diagnosis by analyzing characteristics of imported malaria.Methods The clinical,hemogram and myelogram features of two patients with imported falciparum malaria were analyzed retrospectively.Results Two patients both were staff returning from Africa,firstly without discomfort.When they got a fever,only treated with the anti-viral and antipyretic in local hospitals.When they came to Union Hospital,they had no fever,but peripheral blood cells were reduced,bone marrow proliferated actively to significant actively,young red blood cell proliferated significantly,the malaria parasite Plasmodium falciparum were checked out in peripheral blood and bone marrow at end.Conclusion If person backing from malaria endemic areas such as Africa get a fever,imported malaria should be considered firstly.A peripheral blood smear and a bone marrow smear should be used to look for Plasmodium.