大连市金州区1例输入性恶性疟的诊治分析
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摘要
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.
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.
引文
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[3] 王郭清,段绩辉,张湘君.输入性疟疾流行病学特征及临床表现与诊治情况分析[J].实用预防医学,2017,24 (8):934-937.
[4] 尹授钦,夏尚,周兴武,等.云南省边境地区疟疾传播风险评估[J].中国寄生虫学与寄生虫病杂志,2016,34 (3):255-260.
[5] 王真瑜,张耀光,江莉,等.上海市1例输血性三日疟病例的实验室检测分析与诊断[J].中国血吸虫病防治杂志,2015,27(4):362-366.
[6] 雷蕾,夏志贵,李志宏,等.2012-2015年江西省输入性疟疾病例诊断和报告情况分析[J].中国寄生虫学与寄生虫病杂志,2017 ,35(1):80-84.
[7] 张丽,丰俊,张少森,等.2016年全国疟疾疫情分析[J].中国寄生虫学与寄生虫病杂志,2017,35(6):515-519.
[8] 刘昕亮,邹晏,雷霄,等.乐山市1 例输入性三日疟的实验室检测与诊断[J].寄生虫病与感染性疾病,2018,16(1):4-7.