新疆输入性非洲恶性疟和三日疟4例报告

本文报道新疆某院2018年收治的输入性2例恶性疟和2例三日疟患者的临床表现、实验室诊断特点、治疗、预防情况。4例患者均为外派非洲喀麦隆、利比里亚、尼日利亚和南苏丹务工人员,均有蚊虫叮咬史,回国返疆前后出现发热、寒战、头痛、烦躁等症状入院。实验室快速法检测疟原虫阳性3例,阴性1例;薄血膜涂片镜检可见恶性疟和三日疟不同阶段环状体、裂殖体、配子体等多种形态特点;炎性细胞因子检测：C-反应蛋白增高,L-6、IL-10、IFN-γ、TNF-α均明显增高至数倍,血沉加快,而血象变化不大。用蒿甲醚 80 mg 肌肉注射,1 次/d,或以青蒿琥酯静脉注射120 mg,首次剂量加倍,连续7 d方案治疗,7 d 疟原虫转阴1例,1例转阴时间较长为16 d,4例均治愈,随访2个月,均无复燃。

Four cases of imported African falciparum malaria and quartan malaria infection in Xinjiang

This paper reports the clinical history, laboratory diagnosis, treatment and prevention of two patients with falciparum malaria and two patients with quartan malaria in a hospital in Xinjiang. Four patients were sent to work in Cameroon, Côte d'Ivoire and Nigeria in 2018. They all had a history of mosquito bites. They were admitted to the hospital before and after returning to China for fever, chills, headache, and irritability. Laboratory rapid detection of Plasmodium positive in 3 cases, negative in 1 case; thin blood film smear microscopic examination showed different morphological characteristics of morphological, schizont, and gametophytic bodies in different stages of falciparum malaria and quartan malaria; the detection of inflammatory cytokines found C-reactive protein increased, IL-6, IL-10, IFN-γ, TNF-α were significantly increased several times, ESR accelerated, and blood changes were not significant. After 80 mg of artemether was intramusculally injected once a day, or 120 mg of artesunate was intravenously injected once a day, the first dose was doubled, and the treatment was continued for 7 days. One patient became negative after 7 days, and one patient remained negative for 16 days. All 4 patients were cured. The patients were followed up for 2 months without recurrence.