Multi-organ involvement of tuberculosis--case report of an atypical presentation

A case involving tuberculosis of multiple organs and mimicking carcinoma in several respects is presented.     

1例来自孟加拉国的青蒿素耐药恶性疟病例分析

收集并分析了联合国驻刚果(金)稳定特派团中国二级医院于2021年2月20日收治的1例来自孟加拉国的青蒿素耐药恶性疟病例的临床资料和实验室检查,讨论了青蒿素耐药目前的现状及相关治疗,为救治青蒿素耐药恶性疟提供思路。该患者主因“高热伴腹痛,呕吐3 d”入院。自诉曾3次得过“疟疾”并痊愈。入院前曾在乌维拉一级医院接受过蒿甲醚治疗(具体不详)。查血涂片及疟疾快速诊断试验诊断为恶性疟,血中疟原虫密度计数43 008/μL。血小板数40×10⁹/L,谷丙转氨酶174 U/L,谷草转氨酶292 U/L,总胆红素38.2μmol/L。予以青蒿琥酯注射治疗2 d后,患者仍有发热,但呕吐症状减轻。2月23日使用口服复方双氢青蒿素片治疗,效果不佳,考虑青蒿素耐药可能。2月25日开始使用奎宁联合多西环素的7 d治疗,随后患者体温恢复正常。复查血中疟原虫清除,肝肾功能正常,患者于3月4日办理出院。28 d随访无复发。     

Radio-Ulnar synostosis. an unusual presentation of an isolated ulnar Fracture - Case report

This case outlines an unusual presentation of an isolated ulnar fracture which presented for the first time as an established radio ulnar synostosis causing marked restriction of supination and pronation of the forearm. Radioulnar synostosis following an isolated ulnar fracture is a rare occurrence.     

非典型表现的神经纤维瘤病

神经纤维瘤病（NF）被认为是一种神经外胚层异常性疾病，其临床表现有神经纤维瘤、多发性牛奶咖啡斑、擦烂性雀斑样斑点和Lisch结节。嵌合现象能解释此病的非典型表现。组织分化前的早期突变导致了此病的全身性泛发。作者报道1例非典型的神经纤维瘤病患者，表现为神经纤维瘤异常性分布，在躯于出现临床与病理上均特殊的神经纤维瘤合并卵巢浆液性囊性腺纤维瘤。     

Recurrent and persistent pityriasis rosea: an atypical case presentation

We report a case of atypical pityriasis rosea in a 24-year-old Malay man. He presented with an 11-month history of three recurrent and persistent episodes of pityriasis rosea associated with oral ulcers. The first episode lasted for one month and recurred within 14 days. The second episode lasted for three months and recurred within nine days. The third episode lasted for seven months. Although all three episodes were not preceded by any prodromal symptoms, a herald patch was noted on three different sites (the left iliac fossa, abdomen and chest) on each successive episode. Recurrent pityriasis rosea and its association with oral ulcers, although quite uncommon, have been reported in the literature. However, reports of multiple recurrences, with prolonged duration of each episode and very short remissions in between, have not been made. To the best of our knowledge, this is the first report of such unique presentation.     

恶性疟治疗的前景

全世界每年死于疟疾的病人超过 2 0 0万。WHO已将非洲、东南亚的恶性疟列为全球疾病控制的重点。治疗恶性疟的难点在于其对新抗疟药极易产生抗药性 ,以及多重抗药性虫株的迅速蔓延。1　恶性疟原虫的抗药机理195 7年首先在泰国观察到疟原虫对氯喹抗药。195 9年相继在哥伦比亚、委内瑞拉发现疟原虫抗药性 ,而后几乎世界所有的恶性疟疾流行区均报告疟原虫对不同的抗疟药产生抗药性。1.1　抗叶酸盐类属于该类的药物有乙胺嘧啶 (pyrimethamine ,PYR)、氯胍 (proguanil,PG )、磺胺多辛 (sulfadoxine ,SDX)、磺胺甲氧吡嗪 (sulfalene)等。PYR…     

1例以腹泻为首发症状的输入性恶性疟感染病例报道

探讨一例以腹泻为首发症状的输入性疟疾病例的临床特征和流行病学资料,为输入性疟疾诊冶及预防提供参考资料.收集该病例实验室检测结果、临床诊治经历及流行病学等资料并进行分析.该患者疟疾发作以腹泻为首发症状,血细胞分析:白细胞计数(WBC)5.02×109/L,红细胞计数(RBC)3.91×1012/L,血红蛋白(HGB)13...     

Chloroquine-resistant Plasmodium falciparum malaria in Vanuatu

Cases of malaria caused by Plasmodium falciparum resistant to chloroquine treatment have been probably occurring in Vanuatu for many years. In this survey, seven patients with P. falciparum malaria were investigated for evidence of resistance to chloroquine. In-vitro resistance to chloroquine was demonstrated in four. Two further patients who had clinical resistance to chloroquine treatment developed cerebral malaria. It is of interest that one of these patients was subsequently successfully treated with mepacrine. Two additional cases are cited as examples of resistance to chloroquine treatment encountered in the past.     

Subarachnoid haemorrhage in Plasmodium falciparum malaria

A 41 year old man with cerebral malaria was found to have numerous bilateral retinal haemorrhages and very high parasitaemia. Despite intensive treatment his condition deteriorated and he died. Autopsy showed subarachnoid haemorrhage, which has not been previously described in cerebral malaria.