Yung-Che Chou, Yu-Ta Lin, Si-Yu Chen, Yu-Wei Tseng, Tze-Kiong Er
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引用次数: 0
Abstract
Background: Entamoeba histolytica, a protozoan parasite, is responsible for intestinal amebiasis and can cause severe complications. It is prevalent in tropical and subtropical regions and is a significant health concern in developing countries. Traditional diagnostic methods often delay the diagnosis, leading to prolonged patient suffering and increased risk of complications.
Methods: We report the case of a 59-year-old HIV-positive man on Odefsey, who presented with a week-long history of abdominal pain and diarrhea. Initial stool analysis suggested bacterial colitis, and empirical treatment with levofloxacin was initiated. However, the patient's condition worsened, resulting in hospitalization. Laboratory findings included elevated white blood cell count and high-sensitivity C-reactive protein, with low plasma sodium and potassium levels. Stool bacterial cultures were negative for common pathogens.
Results: Rapid diagnosis was achieved using the FilmArray GI Panel, which detected E. histolytica within an hour. Subsequent stool microscopy suggested the presence of E. histolytica/E. dispar cysts. Prompt antiamoebic therapy with metronidazole and paromomycin resulted in significant clinical improvement. The case was reported to the Centers for Disease Control (CDC) as a Category II notifiable disease.
Conclusions: This case underscores the critical role of the FilmArray GI Panel in the rapid detection of E. his-tolytica, facilitating timely and effective treatment. Early diagnosis using advanced molecular diagnostics significantly improves patient outcomes and should be incorporated into routine clinical practice for managing gastrointestinal infections.
背景:溶组织内阿米巴是一种原生动物寄生虫,可引起肠道阿米巴病,并可引起严重并发症。它在热带和亚热带地区流行,是发展中国家的一个重大健康问题。传统的诊断方法往往延误诊断,导致患者的痛苦延长,并发症的风险增加。方法:我们报告一个59岁的艾滋病毒阳性男子在奥德赛,谁提出了一个星期的腹痛和腹泻的历史。最初的粪便分析提示细菌性结肠炎,并开始了左氧氟沙星的经验性治疗。然而,病人的病情恶化,导致住院。实验室结果包括白细胞计数和高敏c反应蛋白升高,血浆钠和钾水平低。粪便细菌培养对常见病原体呈阴性。结果:使用FilmArray GI Panel快速诊断,可在1小时内检测到溶组织芽胞杆菌。随后的粪便显微镜检查显示存在溶组织大肠杆菌/大肠杆菌。dispar囊肿。及时用甲硝唑和帕罗霉素进行抗阿米巴治疗可显著改善临床症状。该病例被报告给疾病控制中心(CDC)作为第二类应通报疾病。结论:该病例强调了FilmArray GI Panel在快速发现他型溶血性大肠杆菌,促进及时有效治疗方面的关键作用。早期诊断采用先进的分子诊断显著改善患者的结果,应纳入常规临床实践,以管理胃肠道感染。
期刊介绍:
Clinical Laboratory is an international fully peer-reviewed journal covering all aspects of laboratory medicine and transfusion medicine. In addition to transfusion medicine topics Clinical Laboratory represents submissions concerning tissue transplantation and hematopoietic, cellular and gene therapies. The journal publishes original articles, review articles, posters, short reports, case studies and letters to the editor dealing with 1) the scientific background, implementation and diagnostic significance of laboratory methods employed in hospitals, blood banks and physicians'' offices and with 2) scientific, administrative and clinical aspects of transfusion medicine and 3) in addition to transfusion medicine topics Clinical Laboratory represents submissions concerning tissue transplantation and hematopoietic, cellular and gene therapies.