疟疾视网膜病变的临床方面:一项重要综述。

IF 4.9 4区 医学 Q1 PARASITOLOGY Pathogens and Global Health Pub Date : 2023-07-01 Epub Date: 2022-10-19 DOI:10.1080/20477724.2022.2128568
Ketan Raymond Nair Brodeur, Anderson Herculano, Karen Oliveira
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引用次数: 1

摘要

这篇综述将更好地了解一系列被称为疟疾视网膜病变的体征。发现这种与脑型疟疾相关的视网膜病变很重要,因为它能最好地将真正的脑型疟疾患者与其他原因引起的昏迷和偶发的恶性疟原虫寄生虫血症患者区分开来。识别患有疟疾视网膜病变的昏迷患者可以增加准确诊断为严重或脑型疟疾的可能性。由于世界卫生组织没有具体说明疟疾视网膜病变是确定脑型疟疾诊断的因素之一,因此脑型疟疾的诊断存在显著的假阳性。一旦确定了脑型疟疾的诊断,通常会排除其他可能性和治疗方法,从而使脑型疟疾诊断错误可能致命。然而,恶性疟原虫也可能导致一些视网膜病阴性脑型疟疾儿童昏迷,因为这一群体的临床特征仍然不明确,因此所有符合世界卫生组织脑型疟疾定义的儿童都应接受严重疟疾治疗。然而,通过提高对疟疾视网膜病变的认识,可以更大地准确诊断脑疟疾,从而在未来实现更积极的患者结果。这篇文献综述旨在通过定义非专家对视网膜病变的认识,解释其病理学,阐明准确诊断疟疾视网膜病变所需的技术,以及阻碍临床医生在疟疾流行地区提供正确诊断的障碍;最后,讨论了今后继续研究疟疾视网膜病变的方向。
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Clinical aspects of malarial retinopathy: a critical review.

This review will provide a better understanding of a set of signs known as malarial retinopathy. The discovery of this retinopathy in association with cerebral malaria is important because it best distinguishes patients with true cerebral malaria from those with coma due to other causes and incidental Plasmodium falciparum parasitemia. Identifying a comatose patient with malarial retinopathy increases the likelihood of an accurate severe or cerebral malaria diagnosis. As the World Health Organization does not specify that malarial retinopathy is one of the factors included in determining a cerebral malaria diagnosis, there are significant false-positive diagnoses of cerebral malaria. Once a cerebral malaria diagnosis is assigned, other possibilities and treatments are often excluded making an incorrect diagnosis of cerebral malaria potentially fatal. However, Plasmodium falciparum may also contribute to coma in some children with retinopathy-negative cerebral malaria, as this group is still not clinically well characterized, so all children with the WHO definition of cerebral malaria should be treated for severe malaria. Nevertheless, by raising awareness about malarial retinopathy, there could be a greater potential to accurately diagnose cerebral malaria and thus achieve more positive patient outcomes in the future. This literary review aims to raise awareness of the retinopathy by defining what it is to non-experts, explaining its pathology, clarifying the techniques needed to accurately diagnose malarial retinopathy, as well as the barriers that prevent clinicians from providing a proper diagnosis in malaria-endemic regions; and finally, discuss future directions to continue the study of malarial retinopathy.

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来源期刊
Pathogens and Global Health
Pathogens and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-PARASITOLOGY
CiteScore
6.00
自引率
0.00%
发文量
60
审稿时长
6-12 weeks
期刊介绍: Pathogens and Global Health is a journal of infectious disease and public health that focuses on the translation of molecular, immunological, genomics and epidemiological knowledge into control measures for global health threat. The journal publishes original innovative research papers, reviews articles and interviews policy makers and opinion leaders on health subjects of international relevance. It provides a forum for scientific, ethical and political discussion of new innovative solutions for controlling and eradicating infectious diseases, with particular emphasis on those diseases affecting the poorest regions of the world.
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