Severe Plasmodium knowlesi infection with multi-organ failure imported to Germany from Thailand/Myanmar

Malaria Journal

Case Report

Cathrine Haller¹  Stefan Sack¹  Jan Hesse¹  Wulf Hartmann¹  Clemens Wendtner²  Wolfgang Guggemos²  Thomas Fenzl²  Michael Seilmaier²  Adinda Harle³  Nicole Berens-Riha³  Marcus Beissner³  Gisela Bretzel³  Thomas Löscher³ 

[1] Department of Cardiology, Pneumology, and Intensive Care Medicine, Klinikum Schwabing, Akademisches Lehrkrankenhaus der Ludwig-Maximilians-Universität, Kölner Platz 1, 80804, Munich, Germany;Department of Haematology, Oncology, Immunology, Palliative Care, Infectious Diseases and Tropical Medicine, Klinikum Schwabing, Akademisches Lehrkrankenhaus der Ludwig-Maximilians-Universität, Kölner Platz 1, 80804, Munich, Germany;Department of Infectious Diseases and Tropical Medicine (DITM), University Hospital, Ludwig-Maximilians-University, Leopoldstrasse 5, 80802, Munich, Germany;

关键词: Plasmodium knowlesi;    Imported malaria;    Severe malaria;    Multi-organ failure;   

DOI  :  10.1186/1475-2875-13-422

 received in 2014-04-14, accepted in 2014-07-08,  发布年份 2014

来源: Springer

【 摘 要 】

During the last two decades human infections with Plasmodium knowlesi are increasingly diagnosed in South East Asia and have also been reported in travellers. A severe case of imported P. knowlesi infection in a 73-year old German is presented, who had been travelling through Myanmar and Thailand for three weeks. Microscopy showed a parasitaemia of 3% and different parasite stages including band-forms resembling Plasmodium malariae. Due to the clinical picture of severe malaria and the microscopical aspect (combination of parasites resembling P. malariae and Plasmodium falciparum), P. knowlesi was suspected. The patient was treated with intravenous quinine; he was put on mechanical ventilation and catecholamines due to cardiorespiratory failure. Parasitaemia was cleared rapidly but renal function deteriorated resulting in intermittent haemodialysis. The patient was hospitalized for six weeks but he recovered completely without any physical sequelae. Plasmodium knowlesi mono-infection was confirmed by molecular methods later on.Plasmodium knowlesi infection has to be taken into account in feverish travellers returning from Thailand/Myanmar. Moreover this species can cause life-threatening or even lethal complications. Accordingly severe P. knowlesi infection should be treated like severe P. falciparum infections.

【 授权许可】

CC BY   
© Seilmaier et al.; licensee BioMed Central Ltd. 2014