A FATAL CASE OF INDUCED CEREBRAL MALARIA DUE TO PLASMODIUM FALCIPARUM
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概要
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A 21-year-old nurse was admitted to Tenri Hospital on June 25, 1973 in comatous state. She had neither been to the malarial endemic area nor been transfused. However, three weeks before admission she had taken care of a patient with falciparum malaria as a nurse for two days. Six days before admission she had suffered from fever and headache. And three days before admission she had lapsed into coma.<BR>The thin blood films revealed <I>Plasmodium, falciparum</I> parasites. The parasite count was 4, 230/cmm, erythrocyte count was 423 × 10<SUP>4</SUP>/cmm, and leucocyte count was 14, 300/cmm.<BR>She was administered 600 mg of chloroquine, 1, 000 mg of sulformethoxine and 50 mg of pyri-methamine through a stomach tube, but she died 4 hours after her admission.<BR>Necropsy findings were as follows : (a) Macroscopic findings; the brain was violet in color and splenomegaly, 330 g, was seen. Several small bleeding foci were seen in the gastrointestinal tracts and respiratory organs. (b) Microscopic findings; malarial parasites were revealed in the red blood cells of many organs, especially of the brain, spinal cord, spleen, liver, lungs and lymph nodes. Malarial pigments were demonstrated in the spleen, liver, lymph nodes, heart, lungs, kidneys, ovaries, uterus and bone marrow.<BR>Possible infectious course of this case was discussed. It was presumable that the source of the infection was an imported falciparum malaria case and that she was accidentaly, artificially and directly infected through nursing.
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