NEJM:间日疟原虫-案例报道

2016-09-23 MedSci MedSci原创

患者男性,24岁,来自于厄立特里亚因寻求庇护到达瑞士,近日因经常发热到急诊部就诊。  据该患者称,在过去的3年内,几乎每隔2个月,他就出现一次发热症状。  体格检查和常规血液检查发现轻度贫血和转氨酶水平升高。  快速抗原检测试验对疟疾呈阳性反应。  血涂片试验结果显示鞭毛生物的存在。最初怀疑患者疾病的发病与寄生虫感染有关,如微丝蚴、螺旋体或包柔氏螺旋

患者男性,24岁,来自于厄立特里亚因寻求庇护到达瑞士,近日因经常发热到急诊部就诊。

 
据该患者称,在过去的3年内,几乎每隔2个月,他就出现一次发热症状。

体格检查和常规血液检查发现轻度贫血和转氨酶水平升高。

快速抗原检测试验对疟疾呈阳性反应。

血涂片试验结果显示鞭毛生物的存在。最初怀疑患者疾病的发病与寄生虫感染有关,如微丝蚴、螺旋体或包柔氏螺旋体菌,最终识别该患者感染的寄生虫为间日疟原虫。

一般情况下,疟原虫只存在于蚊子体内,但如果血液长期暴露在空气中一段时间,也可在血涂片镜下可见疟原虫的存在。

本案例中的患者,最后在会诊医师的建议下应用蒿甲醚–本芴醇和伯氨喹药物进行治疗,在随后6个月的随访中其未见有反复发热的症状出现。 

原始出处: 

Brenno Balestra, M.D., and Luisa Carnino, M.D. In Vitro Exflagellation of Plasmodium vivax.N Engl J Med 2016; 375:e27September 22, 2016  

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1988125, encodeId=fc5a198812565, content=<a href='/topic/show?id=1b9f9e2582d' target=_blank style='color:#2F92EE;'>#间日疟#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97258, encryptionId=1b9f9e2582d, topicName=间日疟)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Sun Oct 30 23:08:00 CST 2016, time=2016-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=147774, encodeId=fea514e77438, content=文章真好,喜欢阅读, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Thu Oct 13 14:48:46 CST 2016, time=2016-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=144370, encodeId=4ef11443e01f, content=好文章,长见识, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 15:03:19 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1387838, encodeId=d40f138e83848, content=<a href='/topic/show?id=25ffe04313d' target=_blank style='color:#2F92EE;'>#疟原虫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70431, encryptionId=25ffe04313d, topicName=疟原虫)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7e622500011, createdName=12498484m46(暂无昵称), createdTime=Sun Sep 25 04:08:00 CST 2016, time=2016-09-25, status=1, ipAttribution=)]
    2016-10-13 1e10c84am36(暂无匿称)

    文章真好,喜欢阅读

    0

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    2016-10-11 1e10c84am36(暂无匿称)

    好文章,长见识

    0

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