Johanna Eggeling, Michael Ramharter, Dominic Wichmann, Stefan Schmiedel
{"title":"[一名从桑给巴尔返回的女性旅行者因恶性疟原虫引起的严重并发症疟疾]。","authors":"Johanna Eggeling, Michael Ramharter, Dominic Wichmann, Stefan Schmiedel","doi":"10.1055/a-2359-7083","DOIUrl":null,"url":null,"abstract":"<p><strong>Medical history: </strong> A 25-year-old female outpatient presenting with fever and micro-hematuria was treated for urinary tract infection. Her condition worsened over 3 days at home. After experiencing multiple falls caused by leg weakness and mental confusion, she was admitted to a hospital with high fever.</p><p><strong>Diagnostics: </strong> Initial laboratory findings showed hemolytic anemia, pancytopenia, and acute kidney injury, suggesting hemolytic uremic syndrome. However, a detailed fever evaluation revealed her recent return from Afrika. This prompted a malaria test, which confirmed Plasmodium falciparum infection with 80 % parasitemia.</p><p><strong>Therapy and progress: </strong> Despite the quick reduction of parasitemia following treatment with intravenous administered artesunate and oral Artemether-Lumefantrine, her condition worsened, leading to a septic shock. This required renal replacement and kinetic ventilation therapy, as well as blood transfusions due to persistent hemolysis until the laboratory values normalized after 48 days post-admission.</p><p><strong>Conclusion: </strong> The evaluation of fever is often challenging, but most often a detailed patient history is key to early diagnosis and treatment preventing deathly outcomes in severe cases.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"149 18","pages":"1090-1093"},"PeriodicalIF":0.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Severe complicated malaria caused by Plasmodium falciparum in a female traveler returning from Zanzibar].\",\"authors\":\"Johanna Eggeling, Michael Ramharter, Dominic Wichmann, Stefan Schmiedel\",\"doi\":\"10.1055/a-2359-7083\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Medical history: </strong> A 25-year-old female outpatient presenting with fever and micro-hematuria was treated for urinary tract infection. Her condition worsened over 3 days at home. After experiencing multiple falls caused by leg weakness and mental confusion, she was admitted to a hospital with high fever.</p><p><strong>Diagnostics: </strong> Initial laboratory findings showed hemolytic anemia, pancytopenia, and acute kidney injury, suggesting hemolytic uremic syndrome. However, a detailed fever evaluation revealed her recent return from Afrika. This prompted a malaria test, which confirmed Plasmodium falciparum infection with 80 % parasitemia.</p><p><strong>Therapy and progress: </strong> Despite the quick reduction of parasitemia following treatment with intravenous administered artesunate and oral Artemether-Lumefantrine, her condition worsened, leading to a septic shock. This required renal replacement and kinetic ventilation therapy, as well as blood transfusions due to persistent hemolysis until the laboratory values normalized after 48 days post-admission.</p><p><strong>Conclusion: </strong> The evaluation of fever is often challenging, but most often a detailed patient history is key to early diagnosis and treatment preventing deathly outcomes in severe cases.</p>\",\"PeriodicalId\":93975,\"journal\":{\"name\":\"Deutsche medizinische Wochenschrift (1946)\",\"volume\":\"149 18\",\"pages\":\"1090-1093\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Deutsche medizinische Wochenschrift (1946)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1055/a-2359-7083\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/8/29 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Deutsche medizinische Wochenschrift (1946)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1055/a-2359-7083","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/29 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
[Severe complicated malaria caused by Plasmodium falciparum in a female traveler returning from Zanzibar].
Medical history: A 25-year-old female outpatient presenting with fever and micro-hematuria was treated for urinary tract infection. Her condition worsened over 3 days at home. After experiencing multiple falls caused by leg weakness and mental confusion, she was admitted to a hospital with high fever.
Diagnostics: Initial laboratory findings showed hemolytic anemia, pancytopenia, and acute kidney injury, suggesting hemolytic uremic syndrome. However, a detailed fever evaluation revealed her recent return from Afrika. This prompted a malaria test, which confirmed Plasmodium falciparum infection with 80 % parasitemia.
Therapy and progress: Despite the quick reduction of parasitemia following treatment with intravenous administered artesunate and oral Artemether-Lumefantrine, her condition worsened, leading to a septic shock. This required renal replacement and kinetic ventilation therapy, as well as blood transfusions due to persistent hemolysis until the laboratory values normalized after 48 days post-admission.
Conclusion: The evaluation of fever is often challenging, but most often a detailed patient history is key to early diagnosis and treatment preventing deathly outcomes in severe cases.