青岛市2018年1例疟疾死亡病例分析

目的分析青岛市2018年1例输入性恶性疟的死亡原因,为预防疟疾死亡病例发生提供参考。方法访谈接诊医生及患者家属,对患者病历和流行病学调查资料进行分析。结果患者刘某,男,35岁,青岛市城阳区人,2018年3月19日到科特迪瓦务工,7月17日回国。25日患者到韩国办事,26日下午出现发冷、发热、出汗、头痛、浑身酸痛等症状,26-27日自服退烧药无好转,28日上午到韩国某医院就诊,未明确诊断,下午出现腹泻、呕吐症状,29日下午回国,14∶59到城阳区人民医院就诊,精神萎靡,经询问患者有非洲出国史可能患疟疾,16∶30将患者转诊至疟疾治疗定点医院,17∶50到达青岛市传染病医院时患者呈深昏迷状态,医生考虑患者病情危重且该院正在改建无ICU病房,建议转至有抢救条件的综合医院抢救。19:40患者转入海慈医疗集团ICU病房,21∶00被确诊为恶性疟,因病情危重,患者于30日14∶15死于多脏器功能衰竭。结论对于输入性疟疾,根据流行病学史、临床症状和实验室检测结果尽早明确诊断,尽早使用抗疟药治疗,是避免出现死亡病例的关键。

A case of malaria death in Qingdao, 2018

Objective The cause of a death case of imported falciparum malaria in Qingdao in 2018 was analyzed to provide a reference for preventing the recurrence of malaria deaths. Methods Doctors and family members of the patients were interviewed to analyze the patient's medical records and epidemiological survey data. Results Patient Liu, male, 35 years old, from Chengyang District, Qingdao City, went to work in Côte d'Ivoire on March 19, 2018 and returned to China on July 17. On the 25th, the patient went to work in South Korea. On the afternoon of the 26th, he developed symptoms such as chills, fever, sweating, headache, and soreness. From 26th to 27th, he got antipyretics. On the morning of the 28th, he went to a hospital in South Korea for a diagnosis. In the afternoon, symptoms of diarrhea and vomiting occurred. They returned to China on the afternoon of the 29th and went to the People’s Hospital of Chengyang District at 14∶59. After asking the patients, they may have malaria in the history of African.At 16∶30, the patient was referred to the designated hospital for malaria treatment. When the patient arrived at the Qingdao Infectious Disease Hospital at 17∶50, the patient was in a deep coma. The doctor considered that the patient was seriously ill and the hospital was remodeling without an ICU ward. It is recommended to transfer to a rescue condition. At 19∶40, the patient was transferred to the ICU ward of Haici Medical Group. He was diagnosed with falciparum malaria at 21∶00. He died of multiple organ failure at 14∶15 on the 30th due to his critical illness. Conclusion For imported malaria, the diagnosis should be confirmed as early as possible based on epidemiological history, clinical symptoms and laboratory test results. Applying antimalarial treatment as early as possible is the key to avoiding deaths.