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目的对日照市首例输入性卵形疟病例进行实验室检测,以明确诊断。方法收集患者流行病学资料和血样,分别进行疟疾快速诊断检测(RDT)、疟原虫镜检及巢式PCR检测。结果患者从非洲刚果金务工返乡,回居住地莒县陵阳镇1个月后出现不规则发热、乏力。RDT检测提示为非恶性疟原虫感染。血涂片镜下可见感染红细胞明显变形,呈多种不规则形状;环状体粗大,可见大滋养体期和裂殖体期疟原虫。巢式PCR扩增基因产物长度约800 bp,与卵形疟原虫相符。综合上述结果,该病例诊断为单一卵形疟原虫感染。结论虽然镜检是疟疾诊断的金标准,但卵形疟原虫在镜下很难鉴别,结合PCR检测结果可明确诊断。
Objective To carry out laboratory tests on the first case of imported ovipositive malaria in Rizhao so as to confirm the diagnosis. Methods Epidemiological data and blood samples were collected from patients for rapid diagnosis of malaria (RDT), microscopic examination of malaria parasite and nested PCR. Results The patients returned home from the African Congo gold workers and lived irregularly after 1 month in Lingyang Town, Lixian County. RDT tests suggest non-Plasmodium falciparum infections. Blood smear microscope visible infection of red blood cells significantly deformed, showing a variety of irregular shapes; ring body coarse, visible nourish the body and schizonts during the malaria parasite. The length of nested PCR product was about 800 bp, which was consistent with Plasmodium ovale. Based on the above results, the case was diagnosed as a single Plasmodium ovale infection. Conclusion Although microscopic examination is the gold standard for the diagnosis of malaria, Plasmodium ovale is difficult to identify under the microscope. Combined with the results of PCR, the diagnosis can be clearly made.