Biography
Biography: Mohammad Gharebaghi
Abstract
A 19-year-old man came to the hospital presenting with fever, sweating, cough and myalgia that had persisted for five days at outbreak phase of influenza in IRAN. On physical examination, the patient was febrile (38.5°C axillary), other vital sign was normal and had no respiratory, gastro-intestinal, or circulatory abnormalities and no clinical evidence of any organomegaly. In The first day of admission, blood test results showed pancytopenia, anemia (Hb: 9.6g/dL), leukopenia (3.900/mm3), thrombocytopenia (45,000/mm3), high ESR (65 mm/hr), high CRP (60.4 mg/l), mildly elevated liver enzymes. Peripheral blood smear confirmed pancytopenia without other abnormality. Chest X-ray was normal. On the basis of high prevalence of influenza, he suspected for influenza and undergo for management of this diagnosis. Blood cultures and other laboratory tests were normal. Swabs of throat secretions was negative .Two days after admission while we were waiting for PCR influenza results, pancytopenia intensified (WBC=1600/mm3, plt=52000 and Hb=8 gr/dl). Peripheral blood smear reevaluated. Microscopic slides of thick and thin Giemsa-stained blood smears showed the presence of schizonts of P. vivax . Rapid diagnostic tests (RDTs) also confirmed the presence of P. vivax in the blood sample. In 2009, Iran started a malaria elimination program with a goal to achieve this target by 2025. Total number recorded cases has dropped to less than 200, 90, 89, 0 cases in 2015, 2016, and 2017, 2018 respectively. In the context of the head of the health ministry’s malaria control and prevention bureau, there have been no cases of malaria reported in Iran since March 2018 until the July 2019, this case report is of particular interest, as it is a parable for the success and risks for countries nearing and maintaining malaria elimination status and malaria should be suspected in patients with any febrile illness.