PDF(Pubmed)
Abstract：
Herein, we report a case of uncomplicated falciparum malaria with late parasitological failure in a 45-year-old businessman returning from Ghana. The patient visited the emergency department with high fever, headache, and dizziness. He traveled without antimalarial chemoprophylaxis. Laboratory tests led to the diagnosis of uncomplicated falciparum malaria with an initial density of 37,669 parasites per μL of blood (p/μL). The patient was treated with intravenous artesunate followed by atovaquone/proguanil. He was discharged with improved condition and decreased parasite density of 887 p/μL. However, at follow-up, parasite density increased to 7,630 p/μL despite the absence of any symptoms. Suspecting treatment failure, the patient was administered intravenous artesunate and doxycycline for seven days and then artemether/lumefantrine for three days. Blood smear was negative for asexual parasitemia after re-treatment but positive for gametocytemia until day 101 from the initial diagnosis. Overall, this case highlights the risk of late parasitological failure in patients with imported uncomplicated falciparum malaria.
摘要：
在这里，我们报道了一名45岁的从加纳返回的商人，一例无并发症的恶性疟疾伴晚期寄生虫学失败。病人发高烧到急诊科就诊,头痛,和头晕。他旅行时没有抗疟疾药物预防。实验室测试可诊断出简单的恶性疟疾，初始密度为每μL血液（p/μL）37,669种寄生虫。患者接受静脉青蒿琥酯治疗，然后接受阿托瓦醌/丙胍治疗。病情好转出院，寄生虫密度降低887p/μL。然而,在后续行动中,尽管没有任何症状，但寄生虫密度增加到7,630p/μL。怀疑治疗失败，患者静脉注射青蒿琥酯和多西环素7天,然后静脉注射蒿甲醚/本特林3天.再次治疗后，血液涂片对无性寄生虫血症呈阴性，但对配子细胞呈阳性，直到最初诊断为第101天。总的来说,这一病例凸显了输入性无并发症恶性疟疾患者晚期寄生虫学失败的风险。
