恙虫病表现为巨大脾肿大和大叶性肺炎。

Jonnalagadda Vihari, Adurty Aditya, A Vamsi Krishna, Thammineni Roja, Manasa Elika, Uppu Pooja
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引用次数: 0

摘要

尽管恙虫病的发病率有所上升,但由于其临床表现往往不同,导致医生的怀疑指数较低,因此恙虫病仍然是一种诊断率较低的疾病。恙虫病是一种急性发热性疾病,可引起不明原因的长期发热和热病。其临床表现多种多样,轻者无症状,重者可导致致命的多器官功能障碍。恙虫病的脾肿大很少见报道。我们报告了一名 30 岁男子的病例,他出现发热、肝脏肿大、巨大脾肿大、淋巴结肿大和大叶性肺炎。疟原虫和肠热检测结果均为阴性。骨髓穿刺显示造血功能正常。IgM scrub呈阳性。血清学确诊后,患者开始接受强力霉素治疗,随后肺炎(临床和影像学)、脾脏肿大和淋巴结病迅速完全消退。这凸显了识别这种常见热带疾病罕见临床表现的重要性。由于延误治疗可能会导致并发症和不良后果,因此必须及早诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Scrub typhus presenting with massive splenomegaly and lobar pneumonia.

Scrub typhus is still an underdiagnosed disease despite an increase in incidence as the clinical presentation is often different, leading to a low index of suspicion among doctors. Scrub typhus, an acute febrile disease, is a cause of prolonged fever and pyrexia of unknown origin. It can have varied clinical presentations ranging from mild asymptomatic disease to fatal multi-organ dysfunction. Splenomegaly in scrub typhus has been rarely reported. We report a 30-year-old man presenting with fever, hepatomegaly, massive splenomegaly, lymphadenopathy and lobar pneumonia. Tests for malarial parasite and enteric fever were negative. Bone marrow aspiration showed normal haematopoiesis. IgM scrub was positive. Upon serological confirmation, doxycycline therapy was started followed by a rapid and complete resolution of pneumonia (both clinically and radiologically), splenomegaly and lymphadenopathy. This highlights the importance of recognizing rare clinical manifestations of this common tropical disease. An early diagnosis is required as a delay may lead to complications and a poor outcome.

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