大连市金州区1例输入性恶性疟的诊治分析

Diagnosis and treatment of an imported falciparum malaria in Jinzhou District of Dalian

目的对1例输入性恶性疟病例进行实验室检测和临床治疗分析。方法收集该病例的实验室检测结果和临床资料,并进行流行病学调查。对患者进行血涂片病原学检查、疟疾快速诊断检测及荧光定量检测。结果患者在科特迪瓦疟疾高度流行区务工,入境时无不适感;回国1个月以发热、恶心、畏寒、头痛、肌肉及关节疼痛等症状入院。瑞氏-吉姆萨染色见疟原虫环状体,RDT和qPCR检测结果均显示恶性疟原虫感染。给予患者双氢青蒿素哌喹片0.5 g/次,一日服用一次,首剂加倍;伯氨喹40 mg/次,一日服用一次,治疗一个月症状好转。结论镜检、RDT及qPCR三联检测能提高疟原虫的检出率,为患者临床诊治提供依据。

Objective To analyze laboratory tests and clinical treatment of an imported falciparum malaria case.Methods Laboratory test results and clinical data of the case were collected and an epidemiological survey was conducted.The patient was diagnosed with pathogen examination of blood smear,rapid diagnostic test(RDT) and fluorescence quantitative PCR(qPCR).Results The patient worked in the highly populated malaria area of Ivory Coast,and felt no discomfort when entered the country.He was hospitalized with clinical symptoms of fever,nausea,chills,headache,muscle and joint pain one month after returning to China.The results of Wright-Gimsa staining,RDT and qPCR showed the patient was infected with Plasmodium falciparum.The patient was given dihydroartemisinin piperaquine 0.5 g,once a day,and the first dose was doubled;primaquine 40 mg,once a day.The symptoms improved after one month of treatment.Conclusion The detection of microscopic examination,RDT and qPCR improved the detection rate of malaria parasites,providing a basis for clinical diagnosis and treatment.