鼠斑疹伤寒:一种具有神经系统表现和后遗症的蚤传立克次体病的评述

IF 3.4 Q2 INFECTIOUS DISEASES
Lucas S. Blanton
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引用次数: 0

摘要

鼠斑疹伤寒是一种由立克次体引起的急性发热性疾病,立克次体是一种专性细胞内革兰氏阴性球菌。鼠(家鼠)和鼠蚤(印鼠外蚤)分别是斑疹伤寒的宿主和媒介。当感染斑疹伤寒的跳蚤粪便被摩擦到跳蚤咬伤的伤口或粘膜上时,人类就会感染斑疹伤寒。这种疾病在世界大部分地区都是地方性的,特别是在老鼠常见的热带和亚热带沿海地区。鼠斑疹伤寒在德克萨斯州和南加州重新成为发热性疾病的一个重要原因,在那里,交替的传播周期可能涉及负鼠(Didelphis virginia)和猫蚤(Ctenocephalides felis)。虽然主要是一种未分化的发热性疾病,但可出现一系列神经系统症状,特别是在治疗延误时。血清学是诊断检测的主要方法,但确诊通常需要证明急性期和恢复期血清的血清转化或抗体滴度增加四倍(抗体很少在发病的第一周检测到)。因此,首选药物强力霉素的早期经验性治疗是必要的。本文旨在强调鼠斑疹伤寒是一种重要的新发和再发传染病,综述其神经学表现,并讨论需要进一步研究的领域。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Murine Typhus: A Review of a Reemerging Flea-Borne Rickettsiosis with Potential for Neurologic Manifestations and Sequalae
Murine typhus is an acute febrile illness caused by Rickettsia typhi, an obligately intracellular Gram-negative coccobacillus. Rats (Rattus species) and their fleas (Xenopsylla cheopis) serve as the reservoir and vector of R. typhi, respectively. Humans become infected when R. typhi-infected flea feces are rubbed into flea bite wounds or onto mucous membranes. The disease is endemic throughout much of the world, especially in tropical and subtropical seaboard regions where rats are common. Murine typhus is reemerging as an important cause of febrile illness in Texas and Southern California, where an alternate transmission cycle likely involves opossums (Didelphis virginiana) and cat fleas (Ctenocephalides felis). Although primarily an undifferentiated febrile illness, a range of neurologic manifestations may occur, especially when treatment is delayed. Serology is the mainstay of diagnostic testing, but confirmation usually requires demonstrating seroconversion or a fourfold increase in antibody titer from acute- and convalescent-phase sera (antibodies are seldom detectable in the first week of illness). Thus, early empiric treatment with doxycycline, the drug of choice, is imperative. The purpose of this review is to highlight murine typhus as an important emerging and reemerging infectious disease, review its neurologic manifestations, and discuss areas in need of further study.
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来源期刊
Infectious Disease Reports
Infectious Disease Reports INFECTIOUS DISEASES-
CiteScore
5.10
自引率
0.00%
发文量
82
审稿时长
11 weeks
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