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A case of malaria transmitted in Bulgaria from abroad

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ABSTRACT

Introduction. In 1965 Bulgaria was recognized by World Health Ogranization as a malaria-eradicated country. However, isolated cases of malaria imported from endemic countries are diagnosed each year. We will present the case of a patient with cerebral malaria, who travelled in Africa.

Case report. A 36-year old woman was admitted to the hospital with flu-like symptoms. The epidemiologi- cal history of the patient revealed she stayed in Ivory Coast without undertaking chemoprophylaxis, prior to her departure to the African country. The disease started as a flu and coincided with the rise of viral diseases in Bulgaria. Laboratory examinations of na- sal smear by polymerase chain reaction (PCR) did not confirm the initial suspicion. The patient‘s condi- tion deteriorated and additional studies have shown cerebral malaria, caused by Plasmodium falciparum. Despite the complex treatment, the outcome was fatal.

Conclusion. Certain epidemiological and clinical risks generate import of malaria in Europe from endemic countries. The case of cerebral malaria described is the most frequent and severe complication of malaria falciparum. Chemoprophylaxis prior to departure for endemic regions, as well as monitoring of persons returned from those areas, are important for timely discovery, diagnosis and proper treatment of contaminated individuals.

Keywords: cerebral malaria, Plasmodium falciparum, epidemiological risk

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Milena Karcheva, Maria Atanasova and Iskra Rainova

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