Co-infection with COVID-19 and tropical malaria (clinical case)

D. Efremov, Ainur Razifovich Khuramshin, S. S. Кozlov, A. A. Prokhorchik, Nikolay Ivanovich Gulyaev
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Abstract

The article describes a clinical case of co-infection with COVID-19 and tropical malaria. Patient Z., 37 years old, arrived from the Central African Republic with a diagnosis of "New coronavirus infection COVID-19, confirmed (PCR RNA SARS-CoV-2 "+" from 27.01.22) mild form." During an objective examination, the subictericity of the sclera and skin integuments attracted attention, during thermometry - an increase in body temperature to 39.00C. Consciousness at the level of somnolence. Hemodynamics is unstable, episodes of arterial hypotension. Heart rate 96 per minute. Respiratory rate 24 in 1 minute, SpO2 95%, inspiratory dyspnea. According to a laboratory study, severe thrombocytopenia, pronounced signs of hepatic and renal insufficiency, hyperbilirubinemia, an increase in the concentration of C-reactive protein, procalcitonin were revealed. A differential diagnostic search was carried out between acute viral hepatitis and malaria. Blood microscopy revealed young trophozoites of Plasmodium falciparum (++++) using thick drop method. Antimalarial therapy was prescribed with Malacur, which was then replaced with parenteral Quinine followed by mefloquine. In parallel, extracorporeal detoxification operations were carried out. Against the background of adequate etiotropic therapy, complex intensive care measures, the patient's condition was stabilized, on the 40th day the patient was discharged from the hospital with the restoration of health.
COVID-19合并感染和热带疟疾(临床病例)
本文报道1例新冠肺炎合并热带疟疾临床病例。患者Z., 37岁,来自中非共和国,诊断为“新型冠状病毒感染COVID-19,确诊(PCR RNA SARS-CoV-2 +“自22年1月27日起)轻度形式”。在客观检查时,巩膜和皮肤被膜的亚毒性引起了注意,在测温时体温升高到39.00℃。睡意水平上的意识。血流动力学不稳定,动脉低血压发作。心率每分钟96次。呼吸频率24 / 1分钟,SpO2 95%,吸气性呼吸困难。根据实验室研究,严重的血小板减少症,明显的肝肾功能不全,高胆红素血症,c反应蛋白浓度增加,降钙素原显示。在急性病毒性肝炎和疟疾之间进行了鉴别诊断搜索。厚滴法血液镜检发现恶性疟原虫幼滋养体(++++)。抗疟药是用马拉库尔开的,然后用注射奎宁和甲氟喹代替。同时,进行了体外解毒手术。在充分的病因治疗、复杂的重症监护措施的背景下,患者病情稳定,于第40天出院,身体恢复健康。
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