Diagnostic Usefulness of Malaria Antigen and Antibody Rapid Diagnostic Tests for Differential Diagnosis of Plasmodium Vivax Malaria in a Local Emergency Medical Center

PURPOSE: A positive finding on a peripheral blood smear is the gold standard for the diagnosis of malaria. However, even for an expert microscopist, this test is a laborious and time consuming procedure. Therefore, it is crucial to have available a rapid and simple test that can be used in an emergency department environment. The aim of this study was to evaluate the usefulness of a rapid diagnostic kit for vivax malaria antigen and antibody among febrile patients visiting a local emergency medical center. METHODS: Peripheral blood smears, and malaria antigen and antibody tests were evaluated for 593 patients with fever and other commonly associated symptoms of malaria who visited our local emergency medical center between August 2008 and December 2009. RESULTS: Sixty nine cases of vivax malaria were confirmed by peripheral blood smear. Sensitivities of malaria antigen and antibody in patients of malaria were, respectively, 94.20% (65/69) and 76.81% (53/69); specificities were 100% (524/524) and 99.24% (520/524). CONCLUSION: Considering rapidity, high sensitivity and specificity, the rapid malaria antigen test is useful as an adjunctive diagnostic tool for detection of malaria infection in an emergency department environment.

A Case of Intoxication of Ingested Formalin

Formalin is a water-soluble, colorless, pungent, irritating and highly reactive gas. A 40% solution of formaldehyde in water, also known as formalin, is used as a disinfectant, antiseptic, deodorant, tissue fixative and embalming fluid. Ingestion can lead to immediate deleterious effects on almost all systems of the body including gastrointestinal tract, central nervous system, cardiovsacular system and hepato-renal system, causing gastrointestinal hemorrhage, cardiovsacular collapse, unconsciousness or convulsions, severe metabolic acidosis and acute respiratory distress syndrome. We treated a 39-year-old woman who ingested 300 ml formalin in a suicidal attempt. Despite hemodialysis, death occurred after 23 h.