疟疾是一种由多种寄生疟原虫引起的传染病，通过按蚊传播给人类。这种疾病长期以来一直在世界范围内广泛传播，并因后遗症导致大量死亡和生活质量下降。 20 世纪初，随着人们对这种疾病的了解大大增加，人们实施了根除计划以减少疾病传播。这使得主要工业化国家成功消灭了疟疾，至今仍有多个地理区域仍然是疟疾流行区。随着气候变化和移民，由于前往流行区相对容易和病例输入相对容易，疟疾重新引入无疟疾区的风险有所上升。一方面，这是一个重大的公共卫生风险，另一方面，也是对医疗系统的挑战，因为无疟疾地区的医护人员往往没有做好识别、诊断和治疗疟疾病例的准备。在此，我们提出热带（恶性）疟疾并发黑水热（恶性疟疾）的尸检和组织病理学病例报告，具有普遍的肉眼和组织病理学变化，包括样条、肝脏和骨髓中的血黑素沉积；剩余红细胞中可见的寄生形式；中枢神经系统的杜克肉芽肿、淤泥和点状出血；以及肾小管结构内的血红蛋白管型。我们还讨论了将疟疾重新引入无疟疾区的历史和风险 - 保加利亚。版权所有 © 2024，Stoyanov 等人。

Malaria is an infectious disease caused by several types of parasitic plasmodia and transmitted to humans through Anopheles mosquitoes. The disease has long been widespread and has caused a significant number of deaths and decreased life quality from sequelae worldwide. As understanding of the disease increased immensely at the beginning of the 20th century, eradication plans were implemented to decrease disease transmission. This led to the successful eradication of malaria across predominantly industrialized countries, with multiple geographic areas remaining malaria endemic zones to this day. With climate changes and migration, the risk of reintroduction of malaria to malaria-free zones has risen due to relatively easy travel to endemic zones and importation of cases. On the one hand, this is a significant public health risk and, on the other, a challenge to the medical system, as healthcare workers in malaria-free zones are often ill-prepared to recognize, diagnose, and treat malaria cases. Herein, we present an autopsy and histopathology case report of tropical (falciparum) malaria, complicated with blackwater fever (malignant malaria) with prevalent gross and histopathological changes, including hemomelanin deposition in the spline, liver, and bone marrow; visible parasitic forms in the remaining red blood cells; Durk's granulomas, sludge, and petechial hemorrhages in the central nervous system; and hemoglobin casts within the renal tubular structures. We also discuss the history and risk of reintroducing malaria into a malaria-free zone - Bulgaria.Copyright © 2024, Stoyanov et al.