从感染到诊断:一名返程旅客感染恙虫病致多器官功能衰竭1例报告。

IF 3.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Patrick Eaton, Ahmed Ahmed
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引用次数: 0

摘要

恙虫病东方体引起的恙虫病恙虫病是一种由螨叮咬传播的立克次体感染,通常在来自流行地区的旅行者中未得到诊断。本病例报告描述了一名患有高血压的65岁女性,她在前往斯里兰卡旅行后患上了严重的恙虫病。她表现为发热、肌痛、头痛、疲劳和结痂。初步检查显示中性粒细胞增多,淋巴细胞减少,肝酶升高。疟疾被排除在外,并开始了静脉注射他佐辛的经验性治疗。第三天,她出现艰难梭菌感染,需要改用口服万古霉素。第五天,她的病情恶化,出现缺氧、低血压、少尿和肾功能衰竭。胸部x光片显示双侧浸润,随后,她被转入重症监护室。检测显示恙虫病体IgM阳性。开始口服强力霉素,病情迅速好转。PCR确诊为恙虫病。这一病例强调了对来自流行地区出现发热性疾病的旅行者进行早期诊断和强力霉素治疗的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
From Escar to Diagnosis: A Case Report on Scrub Typhus causing multiorgan failure in a Returning Traveler.

Scrub typhus, caused by Orientia tsutsugamushi, is a rickettsial infection transmitted by mite bites, often underdiagnosed in travellers from endemic regions. This case report describes a 65-year-old female with hypertension who developed severe scrub typhus after a trip to Sri Lanka. She presented with fever, myalgia, headache, fatigue, and a scabbed lesion. Initial tests showed neutrophilia, lymphocytopenia, and elevated liver enzymes. Malaria was ruled out, and empiric treatment with intravenous Tazocin was initiated. On day three, she developed Clostridium difficile infection, requiring a switch to oral vancomycin. By day five, her condition worsened with hypoxia, hypotension, oliguria, and renal failure. Chest X-ray revealed bilateral infiltrates and subsequently, she was transferred to critical care. Tests showed positive IgM test for O. tsutsugamushi. Oral doxycycline was started, resulting in rapid improvement. PCR confirmed scrub typhus. This case underscores the importance of early diagnosis and treatment with doxycycline in travellers from endemic areas presenting with febrile illness.

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来源期刊
Clinical Medicine
Clinical Medicine 医学-医学:内科
CiteScore
7.20
自引率
0.00%
发文量
0
审稿时长
6-12 weeks
期刊介绍: Clinical Medicine is aimed at practising physicians in the UK and overseas and has relevance to all those managing or working within the healthcare sector. Available in print and online, the journal seeks to encourage high standards of medical care by promoting good clinical practice through original research, review and comment. The journal also includes a dedicated continuing medical education (CME) section in each issue. This presents the latest advances in a chosen specialty, with self-assessment questions at the end of each topic enabling CPD accreditation to be acquired. ISSN: 1470-2118 E-ISSN: 1473-4893 Frequency: 6 issues per year
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