Analysis of a case of imported malignant malaria death
To analyze the cause of death and artemisinin resistance of an imported malignant malaria case in Wuhan City in 2024,with the aim of accumulating experience in the treatment of severe malaria cases and reduce or avoid the occurrence of severe cases and deaths.Epidemiological data,case investigation forms,clinical diagnosis and treatment data,and laboratory test results of patients were collected and analyzed.The patient,who had worked as a bricklayer in the Democratic Republic of Congo for about 9 months,became ill on the eighth day after returning to China,with no history of malaria.The initial diagnosis of the case was at a private clinic,and there was a misdiagnosis.After 6 days,the condition became severe and the patient was admitted to the hospital.Approximately 8 hours after admission,the patient was diagnosed with malignant malaria and immediately received anti-malarial treatment and symptomatic supportive treatment.Treatment with artesunate injection for 12,24,and 48 hours showed the density of malaria parasites densities of 3.2×105/μL,3.1×105/μL,and 3.1×105/μL,respectively.There was no significant order of magnitude change in the density of malaria parasites compared to before medication,and the count of malaria parasites slightly increased,suggesting the possibility of artemisinin resistance.The patient died of multiple organ failure at 18:30 on January 11,three days after diagnosis.The initial diagnosis occurred in a private clinic where the patient was misdiagnosed.The interval between the onset of the disease and diagnosis was more than 5 d,which resulted in the loss of optimal time for the patient's treatment.At the same time,the malaria parasite-infected by the patient may have artemisinin resistance,which ultimately led to the occurrence of the patient's death.
万方数据
维普
