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目的分析疟疾的血液学检查结果,提高输入性疟疾诊断水平,避免输入性疟疾的漏诊及误诊。方法对1例间断发热,逐渐加重的患者进行流行病学调查,结合临床表现、外周血及骨髓涂片、血常规及肝功能检查,做出正确诊断并指导临床治疗。结果外周血及骨髓涂片发现恶性疟原虫,外周血粒细胞与红细胞两系血细胞减少,诊断为输入性恶性疟疾。经青篙素治疗1周后,患者意识恢复,无发热、咳嗽、咳痰,复查血常规、肝功能等恢复正常。结论对疟疾疫区归国伴发热人员,应及时行外周血涂片查找疟原虫,必要时做骨髓涂片检查,可及时发现输入性疟疾。
Objective To analyze the results of malaria hematology examination, improve the diagnosis of imported malaria and avoid the misdiagnosis and missed diagnosis of imported malaria. Methods A case of intermittent fever and aggravating disease was investigated by epidemiology. Combined with clinical manifestations, peripheral blood and bone marrow smears, blood tests and liver function tests, we made a correct diagnosis and guided the clinical treatment. Results Peripheral blood and bone marrow smears showed that Plasmodium falciparum, peripheral blood granulocytes and erythrocytes were decreased in two blood cells, which was diagnosed as imported malaria. After 1 week of treatment with cantharidin, the patients recovered, no fever, cough, sputum, blood tests, liver function returned to normal. Conclusion For malaria-infected areas returning to the country with fever, we should timely find out the blood samples of peripheral blood smear of malaria parasites, if necessary, do bone marrow smear examination, timely detection of imported malaria.