河南省首例输入性诺氏疟的诊断和分析
Diagnosis and analysis of the first imported case of Plasmodium knowlesi infection in Henan Province

目的:对河南省首例输入性诺氏疟病例进行诊断和分析。方法:收集患者流行病学资料、临床资料及血涂片和抗凝血样本,采用镜检、快速诊断实验(RDT)、巢式PCR及18S rRNA基因序列同源性比较等方法对样本进行实验室检测。结果和结论:患者2017年3月至9月在印度尼西亚从事木材加工工作,回国1周后出现发热、畏寒和出汗等症状,每天夜间发作。镜检血涂片可见典型的诺氏疟原虫形态,RDT阴性,巢式PCR扩增出与诺氏疟原虫序列一致的特异性条带。所得疟原虫18S rRNA基因序列与GenBank中基因序列(登录号为DQ350266.1、L07560.1和AY327554.1)的一致性达99%,确诊为河南省首例输入性诺氏疟原虫感染病例。给予患者磷酸氯喹和磷酸伯氨喹8 d疗法、服药后1周再给予双氢青蒿素磷酸哌喹片治疗,患者痊愈。
Aim:To diagnose and analyze the first imported case of Plasmodium knowlesi(P. knowlesi)infection in Henan Province.Methods: The epidemiological data and clinical manifestations of the patient were collected, as well as the blood smear and anticoagulant blood sample. Microscopy, the rapid diagnostic test(RDT), nested PCR, and the comparing of the 18S rRNA gene were carried out.Results and Conclusion:The patient engaged in logging in Indonesia from March to September in 2017, who had the symptoms of fever, chill and sweating one week after returning. The fever pattern was every night. The typical morphology of P. knowlesi was observed by the microscopic detection. The result of RDT was negative. An amplified band obtained by the nested PCR was consistent with P. knowlesi. The sequence of 18S rRNA was 99% homologous to that of P. knowlesi in GenBank(DQ350266.1,L07560.1 and AY327554.1). The patient recovered after being diagnosed as P. knowlesi infection,and was the first imported case in Henan Province. The patient recovered after being treated with an 8-day therapy with chloroquine and primaquine, and then given dihydroartemisinin-piperaquine tablets one week later