서아프리카에서 유입된 난형열말라리아 1예
A Case of Plasmodium ovale Malaria Imported from West Africa
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한국에서의 해외 유입 말라리아는 삼일열말라리아와 열대열말라리아가 대부분을 차지하며, 난형열말라리아는 드물게 보고되었다. 저자들은 말초혈액도말검사와 이중중합효소연쇄반응으로 확진된 유입된 난형열말라리아 1예를 보고하는 바이다. 환자는 37세남자 환자로 3개월 전 가나에서 체류하였으며 귀국 2주 후부터 발열을 보였으며 말라리아 신속항원 검사에서는 음성을 보였으나 말초혈액에서 말라리아 원충이 관찰되었다. 종 확진 및 혼합감염 여부를 확인하기 위해 시행한 말라리아 종 특이 이중중합효소연쇄반응에서 난형열말라리아 단독 감염을 확인하였으며, 시행한 염기서열 분석에서 본원에서 분리된 난형열말라리아는 P. ovale classic type으로 확인되었다. 결론적으로 난형열말라리아 위험 지역으로의 해외 여행이나 체류가 최근 증가하고 있으므로 유입된 말라리아는 정확한 진단과치료를 위해 난형열말라리아가 확진되어야 한다.
Abstract
In Korea, the majority of imported malaria cases are Plasmodium vivax and P. falciparum, but Plasmodium ovale cases are rarely reported. We describe an imported case of P. ovale that was confirmed by peripheral blood smear and nested PCR targeting the small subunit ribosomal RNA (SSU rRNA) gene. A 37-yr-old male had visited the Republic of Ghana in tropical West Africa 3 months ago, and suffered from fever and headache since 2 weeks after his return to Korea. The results of rapid malaria test using SD Malaria Antigen/Antibody Kit (Standard Diagnostics, Korea) were negative, but Plasmodium species was observed in Wright-Giemsa-stained peripheral blood smear. For the evaluation of possible mixed infection and identification of species, we performed a nested PCR targeting the SSU rRNA gene. P. ovale single infection was confirmed by PCR. The sequence analysis of the P. ovale SSU rRNA gene showed that our isolate was P. ovale classic type. We should confirm P. ovale infection for an accurate diagnosis and treatment of imported malaria cases in Korea because the number of travelers to P. ovale-endemic regions has recently increased.
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