앙골라 여행 후 심한 용혈성빈혈을 보인 혼합 말라리아
A Case of Mixed Malaria Infection with Severe Hemolytic Anemia after Travel to Angola
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
In Korea, Plasmodium vivax (P. vivax) is the most common agent of malaria infection. However, as travel to regions where malaria is endemic increases, so do the numbers of Plasmodium falciparum and mixed infections. P. falciparum predominates, while P. vivax is rare in west-central Africa. We report on a case of mixed malaria infection with severe hemolytic anemia caused by P. falciparum and P. vivax in a 38-yearold man after traveling to Angola. A diagnosis of P. falciparum malaria was made by microscopic examination. However, both P. vivax and P. falciparum were detected by the polymerase chain reaction (PCR). As a radical cure P. vivax , the patient was treated with mefloquine, artemether, and primaquine. Both P. falciparum and P. vivax had disappeared from peripheral blood by admission day 4, however, low grade fever and headache persisted, and his hemoglobin and hematocrit levels were depleted. A peripheral blood smear was negative for both P. vivax and P. falciparum;however, a direct anti-globulin test and anti-nuclear antibody test were positive,suggesting immune hemolytic anemia. After conservative treatment, which included a transfusion with packed red blood cells (RBC), his symptoms and signs showed improvement and laboratory findings were normalized.
Abstract
In Korea, Plasmodium vivax (P. vivax) is the most common agent of malaria infection. However, as travel to regions where malaria is endemic increases, so do the numbers of Plasmodium falciparum and mixed infections. P. falciparum predominates, while P. vivax is rare in west-central Africa. We report on a case of mixed malaria infection with severe hemolytic anemia caused by P. falciparum and P. vivax in a 38-yearold man after traveling to Angola. A diagnosis of P. falciparum malaria was made by microscopic examination. However, both P. vivax and P. falciparum were detected by the polymerase chain reaction (PCR). As a radical cure P. vivax , the patient was treated with mefloquine, artemether, and primaquine. Both P. falciparum and P. vivax had disappeared from peripheral blood by admission day 4, however, low grade fever and headache persisted, and his hemoglobin and hematocrit levels were depleted. A peripheral blood smear was negative for both P. vivax and P. falciparum;however, a direct anti-globulin test and anti-nuclear antibody test were positive,suggesting immune hemolytic anemia. After conservative treatment, which included a transfusion with packed red blood cells (RBC), his symptoms and signs showed improvement and laboratory findings were normalized.
참고문헌 (20)
- "2009 Malaria" (2012)[URL]
- Mehlotra RK., "Random distribution of mixed species malaria infections in Papua New Guinea", Am J Trop Med Hyg, 62, pp.225~231 (2000)
- Nathwani D., "Malaria in Aberdeen : an audit of 110 patients admitted between 1980-1991", Scott Med J, 37, pp.106~110 (1992)
- Krudsood S., "Hidden Plasmodium falciparum infections", Southeast Asian J Trop Med Public Health, 30, pp.623~624 (1999)
- Lyn PC., "Cerebral malaria and mixed falciparum-vivax infections", Ann Acad Med Singapore, 16, pp.310~312 (1987)
- Newton JA. Jr., "Malaria in US Marines returning from Somalia", JAMA, 272, pp.397~399 (1994)
- "Inquérito de Indicadores de Malária em Angola 2011" (2012)[URL]
- Miller LH., "Erythrocyte receptors for(Plasmodium knowlesi)malaria : Duffy blood group determinants", Science, 189, pp.561~563 (1975)
- Mendes C., "Duffy negative antigen is no longer a barrier to Plasmodium vivax-- molecular evidences from the African West Coast (Angola and Equatorial Guinea)", PLoS Negl Trop Dis, 5, pp.e1192~ (2011)
- Shin KS., "A case of Plasmodium vivax infection diagnosed after treatment of imported falciparum malaria", Korean J Lab Med, 21, pp.360~364 (2001)
- Jeong AC., "A case of mixed malarial infection wtih Plasmodium falciparum and Plasmodium vivax", Korean J Infect Dis, 30, pp.194~197 (1998)
- Kim JM., "A mixed cerebral infection of vivax and falciparum malaria", Korean J Lab Med, 20, pp.263~267 (2000)
- Cooper RD., "Malaria vectors of Papua New Guinea", Int J Parasitol, 39, pp.1495~1501 (2009)
- Alifrangis M., "IgG reactivities against recombinant Rhoptry-Associated Protein-1 (rRAP-1) are associated with mixed Plasmodium infections and protection against disease in Tanzanian children", Parasitology, 119(Pt 4), pp.337~342 (1999)
- Drouin J., "Plasmodium falciparum malaria mimicking autoimmune hemolytic anemia during pregnancy", Can Med Assoc J, 132, pp.265~267 (1985)
- Facer CA., "Direct Coombs antiglobulin reactions in Gambian children with Plasmodium falciparum malaria. I. Incidence and class specificity", Clin Exp Immunol, 35, pp.119~127 (1979)
- Daniel Ribeiro CT., "Abnormal anti-single stranded(ss)DNA activity in sera from Plasmodium falciparum infected individuals", Trans R Soc Trop Med Hyg, 78, pp.742~746 (1984)
- Cho SE., "Antinuclear Antibody Production in Patients with Malaria Infection", Korean J Clin Pathol, 21, pp.385~389 (2001)
- Ashley EA., "Evaluation of three parasite lactate dehydrogenase-based rapid diagnostic tests for the diagnosis of falciparum and vivax malaria", Malar J, 8, pp.241~ (2009)
- Okell LC., "Submicroscopic infection in Plasmodium falciparum-endemic populations : a systematic review and meta-analysis", J Infect Dis, 200, pp.1509~1517 (2009)