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發冷發熱的張小姐

發冷發熱的張小姐. Host and Defence (#B03) 林雅玲 May, 2008. 瘧原蟲種類. Plasmodium vivax 間日瘧 Plasmodium falciparum 惡性瘧 Plasmodium malariae 三日瘧 Plasmodium ovale 卵圓瘧. Epidemiology. 全球約五億人口感染瘧疾 每年約一百萬人死於瘧疾 每年超過 500,000 非洲兒童得到腦性瘧疾 在非洲每天大約有 3000 名的兒童因瘧疾而死亡 每 30 秒左右就有一名兒童喪生.

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發冷發熱的張小姐

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  1. 發冷發熱的張小姐 Host and Defence (#B03) 林雅玲 May, 2008

  2. 瘧原蟲種類 • Plasmodium vivax 間日瘧 • Plasmodium falciparum 惡性瘧 • Plasmodium malariae 三日瘧 • Plasmodium ovale 卵圓瘧

  3. Epidemiology • 全球約五億人口感染瘧疾 • 每年約一百萬人死於瘧疾 • 每年超過500,000非洲兒童得到腦性瘧疾 • 在非洲每天大約有3000名的兒童因瘧疾而死亡 • 每30秒左右就有一名兒童喪生 http://www.who.int/malaria/ http://www.rbm.who.int/worldmalariaday/background.html

  4. Transmission of malaria • Mosquito bite- Anopheles • Blood transfusion • Contaminated syringe • Congenital infection

  5. Life cycle in Anopheles minimus(微小瘧蚊) 當雌瘧蚊叮咬人時 配子體(gametocyte) 合子 (zygote) 卵動體 (ookinete) 卵囊體 (oocyst) 孢子小體(sporozoite)

  6. Life cycle in human Sporozoite liver schizont (Pre-erthrocytic stage) hypnozoite (Exo-erthrocytic stage) RBC gametocyte (Erthrocytic stage)

  7. Clinical features and pathology I • General symptoms Headache, Lassitude • Fever Cold stage 1~2 hrs Chillness, temperature mounts rapidly Hot stage 8~12 hrs 39-41oC, rapid pulse, flush Sweating stage 2~4 hrsSweating, temperature falls rapidly

  8. Clinical features and pathology II 3. Parasitemia 4. Hemolyic anemia 5. Jaundice 6. Tropical splenomegaly syndrome 7. Recrudescence • Anemia can be more severe with chronic malaria.

  9. Severe Plasmodium falciparum infection Circulation failure

  10. Severe Plasmodium falciparum infection I • Cerebral malaria • Convulsion • Circulation failure • Renal failure • Abnormal liver function • Pulmonary edema

  11. Severe Plasmodium falciparum infection II 7. Hyperparasitemia 8. Severe anemia 9. High fever 10. Tropical splenomegaly syndrome 12. Hemorrhage in many organs 13. Hemolysis (Blackwater fever) 14. Electrolyte imbalance 15. Hypogylcemia

  12. 臨床診斷 1. History taking 2. Blood smear • Thin film • Thick film 3.Immunodiagnosis 4. Molecular diagnosis

  13. 抗瘧藥物 • Quinine • Chloroquine • Mefloquine • Doxycycline • Pyrimethamine • Primaquine • Proguanil • Artemisinin

  14. 預防 • 避免蚊蟲叮咬 • 避免因輸血而感染 • 出國前詢問相關資訊

  15. 其他議題 • 非洲醫療團 • 面對病人死亡 • 老年喪女

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