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目的对深圳市1例境外输入性2岁幼儿感染三日疟病例进行病例调查及实验室检测分析。方法开展病例个案的流行病学调查,对血样进行涂片镜检,多重PCR扩增检测疟原虫核糖体DNA(r DNA),将PCR扩增片段进行序列测定,BLAST软件比对分析。结果该患儿于2015年8月被家人带往尼日利亚探亲,9月中旬回国,11月初出现反复发热,退热时伴大汗等症状,初步诊断为疟疾并住院治疗。血涂片镜检可见典型的三日疟原虫形态。多重PCR扩增出与三日疟原虫预期一致的特异性条带。PCR产物大小为412 bp,与Gen Bank数据库中国外报道的9株三日疟原虫同源序列比对的一致性均为99%。结论根据流行病学史、临床表现和实验室检测结果判断,确诊该2岁幼儿为一例输入性疟疾病例。血片镜检与核酸检测分析证实为三日疟原虫感染。
Objective To carry out case investigation and laboratory test on 1 case of 2-year-old imported malaria infected by malaria in Shenzhen City. Methods The epidemiological investigation of cases was carried out. The blood samples were microscopically examined by smear microscopy. Multiplex PCR was used to detect the rDNA of the malaria parasite, and the PCR products were sequenced and analyzed by BLAST software. Results The child was brought to Nigeria by his family in August 2015 to visit relatives, returned to China in mid-September, and experienced repeated fever in early November with sweating and other symptoms during fever. The patient was initially diagnosed as malaria and hospitalized. Blood smear microscopy can be seen on the typical form of Plasmodium malaria. Multiplex PCR amplified a specific band expected from Plasmodium malariae. The size of the PCR product was 412 bp, which was 99% identical to the 9 sequences of homologous sequences of Plasmodium maruri reported in Gen Bank database. Conclusion According to the epidemiological history, clinical manifestations and laboratory test results to determine the diagnosis of the 2-year-old child as an example of imported malaria cases. Blood film microscopy and nucleic acid test analysis confirmed as Plasmodium malaria infection.