PMID: 12757689May 22, 2003Paper

Avoiding misdiagnosis of imported malaria: screening of emergency department samples with thrombocytopenia detects clinically unsuspected cases

Journal of Travel Medicine
T HänscheidBernardino G Pinto

Abstract

Misdiagnosis of imported malaria is not uncommon and even abnormal routine laboratory tests may not trigger malaria smears. However, blind screening of all thrombocytopenic samples might be a possible way to detect clinically unsuspected malaria cases in the accident and emergency department (AED). The frequency and degree of thrombocytopenia was determined in two cohorts of malaria patients (Lisbon, Portugal and Berlin, Germany). The frequency of thrombocytopenia in full blood count (FBC) samples from patients presenting at the ED at a large teaching hospital in Lisbon, Portugal, was determined and compared with urgent samples from in-patients, both determined at a dedicated emergency laboratory. A cut-off value was established for screening of all FBC samples from the ED with Giemsa-stained thick-blood films. In 4,362 unselected samples from the ED in Lisbon a thrombocytopenia of <150,000/microL was found in 7% and of <100,000/microL in 2.2% of cases (2.5 samples/day with <100.000/microL). In patients with malaria, a thrombocytopenia was found in 75% and 77% (<150,000/microL) or 53% and 45% (<100,000/microL) in Lisbon, (n=60) and Berlin (n=170), respectively. Blind screening of all samples with <100,000 thrombocytes/microL by...Continue Reading

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Citations

Sep 22, 2005·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Simon M Smith
Feb 2, 2006·Current Infectious Disease Reports·Alan J Magill
Dec 12, 2012·Pediatric Emergency Care·Kevin R Schwartz, Robert Vinci
Jul 27, 2007·Scandinavian Journal of Infectious Diseases·Ida E GjørupIb C Bygbjerg
Mar 24, 2006·Journal of Travel Medicine·Simon M Smith
Oct 27, 2017·Journal of Clinical Microbiology·Thomas Hanscheid, Martin P Grobusch
May 28, 2013·Malaria Journal·Maria M M KaisarJaco J Verweij

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