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首页> 外文期刊>Emerging Infectious Diseases >Avoiding Misdiagnosis of Malaria: A Novel Automated Method Allows Specific Diagnosis, even in the Absence of Clinical Suspicion
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Avoiding Misdiagnosis of Malaria: A Novel Automated Method Allows Specific Diagnosis, even in the Absence of Clinical Suspicion

机译：避免对疟疾的误诊：即使在没有临床怀疑的情况下，新型的自动化方法也可以进行特定的诊断。

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To the Editor: We report three cases of malaria to illustrate a novel method that allows diagnosing the disease, even if clinicians do not suspect it or request malaria smears. Lack of clinical suspicion is a well-known factor for malaria misdiagnosis and may be responsible for almost 40% of deaths from Plasmodium falciparum infections in industrialized countries (1-3). A recent study from Canada showed that in 59% of cases malaria was initially misdiagnosed, and in 16% three or more physician contacts occurred before malaria smears were ordered (4). Early diagnosis of malaria relies crucially on clinical suspicion. A clinician suspecting the disease has to explicitly request malaria smears. This problem has not been solved with the advent of several methods alternative to microscopy, including recently introduced rapid dipstick tests (5). Performing any of these tests blindly without a specific request is impractical. On the other hand, routinely performed laboratory tests in the work-up of febrile patients, e.g., automated full blood counts, have so far detected only nonspecific changes, such as anemia or thrombocytopenia, which are associated with many other conditions (6). These changes on their own are therefore not specific enough to trigger malaria smears without an explicit request.
机译：致编辑：我们报告了3例疟疾病例，以说明一种新颖的方法，即使临床医生不怀疑或要求进行疟疾涂片检查，也可以诊断该疾病。缺乏临床怀疑是导致疟疾误诊的一个众所周知的因素，在工业化国家中，恶性疟原虫感染可能导致近40％的死亡（1-3）。加拿大最近的一项研究表明，在59％的病例中，最初误诊了疟疾，在16％的病例中，在下令进行疟疾涂片检查之前，发生了3次或更多的医生接触（4）。疟疾的早期诊断主要取决于临床的怀疑。怀疑该疾病的临床医生必须明确要求进行疟疾涂片检查。几种替代显微镜的方法尚未解决该问题，包括最近引入的快速量油尺测试（5）。在没有特定要求的情况下盲目地进行任何这些测试都是不切实际的。另一方面，到目前为止，在发热患者的检查中常规进行的实验室检查，例如自动全血细胞计数，迄今为止仅检测到与许多其他情况相关的非特异性变化，例如贫血或血小板减少症（6）。因此，这些变化本身还不够具体，无法在没有明确要求的情况下引发疟疾涂片。

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