中国寄生虫学与寄生虫病杂志

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一个红细胞内同时寄生不同期间日疟原虫输入性病例1例

王加志1,尹雪梅1,李希尚1,尹授钦1,丰俊2*   

  1. 1 云南省腾冲市疾病预防控制中心,腾冲 679100;2 中国疾病预防控制中心寄生虫病预防控制所,世界卫生组织热带病合作中心,科技部国家级热带病国际联合研究中心,卫生部寄生虫病原与媒介生物学重点实验室,上海 200025
  • 出版日期:2016-06-30 发布日期:2016-10-28

An Imported Case of Vivax Malaria with Co-occurrence of Different Stages of Plasmodium vivax in Erythrocyte

WANG Jia-zhi1, YIN Xue-mei1, LI Xi-shang1, YIN Shou-qin1, FENG Jun2 *   

  1. 1 Tengchong County Center for Disease Control and Prevention, Tengchong 679100, China;2 National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention;WHO Collaborating Centre for Tropical Diseases;National Center for International Research on Tropical Diseases, Ministry of Science and Technology;Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China
  • Online:2016-06-30 Published:2016-10-28

摘要: 2012年对云南省腾冲市1例间日疟患者血样采用CareStartTM疟疾快速诊断试剂盒、吉氏染色镜检和巢式PCR方法进行鉴定。CareStartTM疟疾快速诊断试剂盒检测结果判定为除恶性疟原虫以外的间日疟原虫、三日疟原虫或卵形疟原虫感染。镜检结果显示,患者血样厚、薄血片中可见间日疟原虫环状体多核、多重感染现象,1个环状体有2个及以上核的占14.68%(188/1 280);同时寄生2个及以上环状体的红细胞占22.50%(288/1 280);1个红细胞内同时寄生环状体和滋养体、环状体和配子体。巢式PCR结果显示,患者血样为间日疟原虫特异性DNA片段阳性。结合检测结果、流行病学资料和临床表现,确诊该患者为输入性间日疟原虫感染病例,且一个红细胞内同时寄生不同期间日疟原虫。

关键词: 间日疟原虫, 环状体, 多核, 多重感染

Abstract: The blood sample from a case of vivax malaria in Tengchong City, Yunnan Province, was tested with CareStartTM malaria rapid diagnostic test, Giemsa staining and nested PCR in 2012. The case was determined to be infected with Plasmodium vivax, P. malariae or P. ovale other than P. falciparum by CareStartTM malaria rapid diagnostic test. Microscopic results revealed multinuclear P. vivax ring form and multi-infections with P. vivax in blood slides, with occurrence of two or more nuclei in one ring form accounting for 14.68%(188/1 280), and parasitism of two or more P. vivax rings in one erythrocyte accounting for 22.50%(288/1 280). In addition, co-occurrence of ring form and trophozoite, and ring form and gametophyte was found in erythrocytes. Nested PCR revealed P. vivax-specific amplification products. Combining the results with epidemiological information and clinical symptoms, this case was finally diagnosed as imported vivax malaria, and the erythrocytes of the case harbored different stages of P. vivax parasites.

Key words: Plasmodium vivax, Ring stage, Multinuclear, Multi-infection