Post-mortem diagnosis of malaria.
Post-mortem diagnosis of malaria.
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DOI：
10.1002/nmi2.52
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发表时间：
2014-09-01
影响因子：
4
通讯作者：
Greub, G
中科院分区：
文献类型：
--
作者：
Palmiere, C;Jaton, K;Greub, G
由于输入性疟疾引起的突然意外死亡偶尔会发生在非流行地区，并可能导致法医问题[1-4]。在非疟疾流行国家，疟疾的死后鉴定具有挑战性，因为病理学家不经常遇到脑型疟疾[5，6]，而且因为感染很少在死前记录。通常只有在根据既往病史或现有医疗信息怀疑患有疟疾时，才进行疟疾的死后诊断。不幸的是，在尸体被送入太平间进行法医调查时，医疗记录通常不完整、不可靠或没有。此外，尸检时的肉眼观察结果通常是非特异性的[7，8]。在此，我们报告了一个完全未被临床怀疑的疟疾尸检诊断。一名先前健康的48岁白人妇女与她的丈夫一起前往象牙海岸，在南部森林区度过了3周。由于误解了医疗建议，他们只是在前往非洲之前才每周服用氯喹进行疟疾化学预防。在返回瑞士的三天前，她突然出现发烧、发冷、不适和肌肉疼痛。由于流感样症状，她服用阿司匹林。从非洲回来四天后，她被发现死在家里。由于死因不明，检察官下令进行法医尸检，并于当天进行。
Dear Editor Sudden unexpected deaths due to imported malaria occasionally occur in non-endemic areas and can lead to forensic issues [1–4]. Post-mortem identification of malaria in non-endemic countries is challenging because pathologists do not often encounter cerebral malaria [5, 6] and because the infection is rarely documented ante-mortem. Post-mortem diagnosis of malaria is often only done when there is a suspicion based on anamnesis or available medical information. Unfortunately, medical records are generally incomplete, unreliable or absent when bodies are admitted to the mortuary for medico-legal investigations. Moreover, macroscopic findings at necropsy are often non-specific [7, 8].Here, we report a post-mortem diagnosis of malaria, completely unsuspected clinically. Briefly, a previously healthy 48-year-old Caucasian woman travelled to Ivory Coast with her husband, spending 3 weeks in the southern forest zone. They had taken chloroquine weekly for malaria chemoprophylaxis only before travelling to Africa, due to misunderstanding the medical advice. Three days before returning to Switzerland, she suffered abrupt onset of fever, chills, malaise and muscle aches. Due to flu-like symptoms, she self-medicated with aspirin. Four days after returning from Africa, she was found dead at home. As a result of the unclear death, a medico-legal autopsy was ordered by the prosecutor and performed the same day.