深圳市1例输入性恶性疟死亡病例的流行病学调查  

Epidemiological investigation of a death case of imported falciparum malaria in Shenzhen

作　　者：李媛[1] 高世同[1] 许舒乐[1] 梅树江[1] 黄达娜[1] 陈志高[1] LI Yuan;GAO Shitong;XU Shule;MEI Shujiang;HUANG Dana;CHEN Zhigao(Shenzhen Center for Disease Control and Prevention,Guangdong 518055,China)

机构地区：[1]深圳市疾病预防控制中心,广东518055

出　　处：《医学动物防制》2023年第3期306-306,F0003,F0004,共3页Journal of Medical Pest Control

基　　金：深圳市医学重点学科(SZXK064)。

摘　　要：目的对深圳市1例输入性恶性疟死亡病例进行流行病学调查分析,为科学防治恶性疟提供参考依据。方法访谈收治医生和患者家属,收集分析该病例临床和流行病学资料。结果该病例发病前在乌干达务工,2020年1月回国,回国后第10天出现发热、发冷、发汗、头痛、腹泻、全身酸痛等症状,发病第2天前往某民营医院就诊,拟诊为“感染性发热”,服药后症状未见好转。发病第3天进行血液检查,结果显示疟原虫,考虑“疟疾”,予将其转院治疗。入院后,给予蒿甲醚抗疟、抗炎、降颅压、脏器功能支持等对症治疗,然而病情进一步加重。发病第6天该病例因脑型疟、多器官功能衰竭而死亡。血涂片镜检查见恶性疟原虫,PCR基因鉴定为恶性疟原虫。结论综合流行病学史、临床症状和实验室检测结果显示,这是1例输入性恶性疟病例,诊治延误是引起该病例死亡的主要原因。Objective The epidemiological of a death case of imported falciparum malaria in Shenzhen was investigated and analyzed to provide a reference basis for the scientific for the prevention and control of falciparum malaria.Methods Face-to-face interviews were conducted among the doctors and the family members of the patient to collect clinical and epidemiological data.Results The patient went to Uganda for work before the onset of the disease and returned to China on January of 2020.She developed such symptoms as fever,chills,sweating,headache,diarrhea and generalized muscle ache on the 10th day after returning to China.On the 2nd day after onset of the disease,she went to a private hospital and was diagnosed as“infectious fever”.The symptoms were not improved after taking some medicine.On the 3rd day after onset of the disease,plasmodium was observed by blood smear.She was diagnosed as malaria and was transferred to another hospital for treatment.After admission to the new hospital,she was treated by Artemether,anti-inflammatory,cranial pressure lowering and organ function support treatment.But her condition got worse.The patient died of cerebral malaria and multiple organ failure on the 6th day after onset of the disease.Plasmodium falciparum was detected by blood smear and identified by PCR.Conclusion The case is an imported case of falciparum malaria patient on the basis of epidemiological history,clinical symptoms and laboratory test results,and the main cause of death is delayed diagnosis and treatment.

关 键 词：恶性疟 死亡病例 输入性 流行病学调查 脑型疟 深圳市 

分 类 号：R531.3[医药卫生—内科学]