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报告大理学院附属医院2014-02-21接诊1例输入性疟疾病例,对服抗疟药前的血液样品采用镜检、RDT和PCR等3种不同检测方法反复进行疟疾检测,结果均为阴性,仅在骨髓样品中镜检出恶性疟原虫配子体,稍不注意很容易造成漏诊、漏治,漏诊、漏治不仅延误患者治疗和康复,患者作为疟疾传染源长期存在,容易导致疟疾在当地传播,危害周围人群健康,不利于巩固已取得的消疟成果。因此,在以后的工作中,流行病学和临床学资料都支持疟疾的诊断,但血液样品未检测出疟原虫,也不能轻易地否定疟疾的诊断,在有条件的情况下可作骨髓涂片镜检,进一步确诊。即使没有条件作骨髓涂片镜检的,或虽作了骨髓涂片镜检仍为阴性的,也不能轻易否定疟疾诊断,以免漏诊、漏治,确保通过消除疟疾验收地区不再发生本地感染疟疾疫情。
Report Dali Hospital Affiliated Hospital 2014-02-21 Admission 1 case of imported malaria, anti-malarial drugs before the blood samples by microscopic examination, RDT and PCR 3 different detection methods repeated malaria test results were Negative, only in bone marrow samples of Plasmodium falciparum mirror microscopy, a little careless easily lead to misdiagnosis, leakage treatment, missed diagnosis, not only delay treatment and rehabilitation of patients, as a source of malaria infection in patients with long-standing, easily lead to malaria in the local Disseminating and endangering the health of the people around them is not conducive to consolidating the achievements made in eliminating malaria. Therefore, in future work, both epidemiological and clinical data support the diagnosis of malaria but no blood samples detect malaria and can not easily negate the diagnosis of malaria and can be used as a bone marrow smear where available Microscopic examination, further diagnosis. Even if there is no condition for bone marrow smear microscopy, or despite bone marrow smear microscopy is still negative, can not easily negate the diagnosis of malaria, so as to avoid misdiagnosis, missed treatment to ensure that no local infection of malaria through malaria elimination area epidemic.