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目的调查黄岩区一例输入性恶性疟和卵形疟混合感染病例,为疟疾防控提供参考。方法收集病例诊治和流行病学调查资料,采集病例抗凝血作镜检和巢式PCR检测。结果该病例在赤道几内亚务工期间有疟疾发作史和治疗史,在回国后第1天即出现寒战、发热、头痛等疟疾典型临床症状,镜检确诊为恶性疟;给予青蒿琥酯针剂和双氢青蒿素哌喹片治疗后,症状消失。此后在距上次发作的第110天又再次发病,疟疾快速诊断试纸(RDT)检测阴性,镜检误诊为间日疟;后经浙江省疾病预防控制中心巢式PCR检测,判定前后两次发病分别为恶性疟原虫和卵形疟原虫感染。结论该病例是一例输入性恶性疟和卵形疟混合感染病例,今后应加强疟疾类型的鉴别诊断能力,防止漏诊误诊。
Objective To investigate a case of mixed infection of imported falciparum malaria and ovale malaria in Huangyan District and provide reference for prevention and control of malaria. Methods The cases were collected for diagnosis and epidemiological investigation, and the anticoagulant blood was collected for microscopic examination and nested PCR. Results During the period of working in Equatorial Guinea, there was a history of malaria and treatment history. Typical symptoms of malaria such as chills, fever and headache were found on the first day after returning home. The patients were diagnosed as falciparum malaria by microscopic examination. Artesunate injection and double After the treatment with dihydroartemisin and piperaquine tablets, the symptoms disappeared. Since then, the morbidity of malaria diagnostic test paper (RDT) was negative again on the 110th day of the last attack, and the malaria test was misdiagnosed as Vivax malaria. After the disease was detected by nested PCR in Zhejiang Provincial Center for Disease Control and Prevention, Respectively, Plasmodium falciparum and Plasmodium ovale infection. Conclusion This case is a case of imported cases of mixed infection of falciparum malaria and oval malaria. In the future, the differential diagnosis ability of malaria should be strengthened to prevent misdiagnosis.