RESUMEN. El estado Sucre aporta el mayor número de casos de paludismo entre las entidades federales de Venezuela, y es frecuente atender en los hospitales de la ciudad de Caracas, enfermos con esa parasitosis adquirida después de la permanencia en esa área endémica. Se describen seis casos de paludismo adquirido en Sucre como infección del viajero, con el propósito de revisar y analizar las variables clínicas, epidemiológicas y terapéuticas que se observaron durante la atención hospitalaria de este brote epidémico. Los pacientes, de 4 a 44 años de edad, refirieron fiebre, precedida por escalofríos y sudoración profusa posterior, presentaron esplenomegalia y cinco de ellos anemia al examen hematológico. Se les demostró Plasmodium vivax y fueron tratados con cloroquina y primaquina. Un paciente presentó una hemólisis por deficiencia de la enzima glucosa-6-fosfato deshidrogenasa. Se realizan consideraciones sobre la necesidad de relacionar el diagnóstico clínico con la procedencia epidemiológica de los pacientes, para la obtención del diagnóstico presuntivo de las enfermedades tropicales. Los pacientes que acudieron con fiebre y trombocitopenia inicialmente se les diagnosticó dengue. Ha ocurrido en otras oportunidades, es común confundir paludismo con dengue, por la trombocitopenia. Se tiene la respuesta de que fiebre aguda y trombocitopenia no es un diagnóstico presuntivo de dengue. La diferencia se obtiene, antes de concluir el diagnóstico de certeza, por el antecedente de procedencia del paciente de un área endémica de malaria.
ABSTRACT Among the federal states of Venezuela, Sucre contributes with the highest number of malaria cases, and it is common to see in the hospitals located in Caracas, patients who acquired the disease after they have stayed in this endemic area. Six cases of malaria acquired in Sucre are described as traveler infection, to analyze the clinical, epidemiological and therapeutic variables observed during the medical attention of this epidemic outbreak. The patients, between 4 and 44 years old, had had fever, preceded by chills and posterior profuse sweating. They had esplenomegaly, and five of them anemia in laboratoty tests. Plasmodium vivax was demonstrated in all of their blood samples, and they were treated with chloroquine and primaquine. One patient suffered hemolysis by glucose-6-phosphate dehydrogenase enzyme deficiency. Considerations are made of the necessity to establish a relationship between the clinical diagnosis and the epidemiologic situation of the patient to obtain the presumptive diagnosis of any tropical disease. The patients who presented with fever and thrombocytopenia were confused with dengue. It has happened in other opportunities; it is common to confuse malaria and dengue, because of the thrombocytopenia. But the answer is that acute fever and thrombocytopenia are not a presumptive diagnosis of dengue. The difference is obtained, before making the etiological diagnosis, by the history that the patient comes from an malaria endemic area.