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新发传染病电子杂志 ›› 2026, Vol. 11 ›› Issue (4): 70-74.doi: 10.19871/j.cnki.xfcrbzz.2026.04.011

• 病例报道 • 上一篇    下一篇

输入性脑型疟疾继发多器官衰竭成功救治1例

伍婷, 姚伟明, 宋海辉, 罗锦鸿, 黄思然, 王智, 曹炜鹏, 陈小春, 胡丽华, 王福祥, 唐明   

  1. 深圳市第三人民医院感染重症医学科,广东 深圳 518112
  • 收稿日期:2025-12-11 出版日期:2026-08-31 发布日期:2026-09-14
  • 通讯作者: 唐明,Email:273453706@qq.com
  • 基金资助:
    深圳市“三名工程”医学团队项目(SZSM202311033)

Successful treatment of a case of imported cerebral malaria complicated by multi-organ failure

Wu Ting, Yao Weiming, Song Haihui, Luo Jinhong, Huang Siran, Wang Zhi, Cao Weipeng, Chen Xiaochun, Hu Lihua, Wang Fuxiang, Tang Ming   

  1. Department of Infectious and Critical Care Medicine, the Third People's Hospital of Shenzhen City, Guangdong Shenzhen 518112, China
  • Received:2025-12-11 Online:2026-08-31 Published:2026-09-14

摘要: 脑型疟疾(cerebral malaria,CM)是由恶性疟原虫引起的一种常见致命性神经系统疾病,其所引起的神经损伤具有不可逆性和致死性,临床上主要表现为意识障碍和癫痫发作。青蒿琥酯是CM的首选药物,但重症CM临床救治难度大,幸存者可遗留认知功能障碍或行为异常。本研究报道1例成功救治脑型疟疾合并多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)的病例。该患者为一名中国籍中年男性,非洲务工人员,近半年在非洲工作、生活,此次发病以反复发热、寒战为首发症状,伴有精神行为异常、肝肾功能损害及呼吸衰竭。在保障足量、足疗程青蒿琥酯抗疟治疗的基础上,联合抗感染、应用激素、血液净化及机械通气等综合治疗,患者病情趋于稳定,神志转清,各器官功能显著改善。本报告旨在重点探讨CM多系统受累的临床特征及其综合治疗策略,以帮助临床医生对重型疟疾患者实施更精准、有效的救治,从而改善预后,缩短住院时间。

关键词: 脑型疟疾, 多器官功能衰竭, 青蒿琥酯, 综合救治

Abstract: Cerebral malaria (CM) is a common and fatal neurological disorder caused by Plasmodium falciparum. The neurological damage it induces is irreversible and lethal, with clinical manifestations primarily including impaired consciousness and seizures. Artesunate is the first-line treatment for CM, yet the management of severe CM remains clinically challenging, and survivors may experience cognitive impairment or behavioral abnormalities. This study presents a successfully treated case of CM complicated with multiple organ dysfunction syndrome (MODS). The patient was a middle-aged Chinese male who worked as a laborer in Africa and had lived and worked there for six months. He initially presented with recurrent fever and chills, followed by neuropsychiatric symptoms, impaired liver and kidney function, and respiratory failure. On the basis of adequate and full-course artesunate antimalarial therapy, combined with comprehensive treatment including antibiotics, corticosteroids, continuous renal replacement therapy (CRRT), and mechanical ventilation, the patient's condition stabilized. His consciousness cleared, and organ functions showed significant improvement. This report aims to highlight the clinical features of multi-system involvement in CM and its comprehensive treatment strategies, in order to assist clinicians in providing more targeted and effective treatment for patients with severe malaria, thereby improving prognosis and reducing hospital stays.

Key words: Cerebral malaria, Multiple organ failure, Artesunate, Comprehensive therapy

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