未完全成熟的魏氏病:钩端螺旋体引起的急性肝炎的一种非典型病因

Amir Omar , Rayane Salameh , Tracy Zouein , Tala Charafeddine , Karam Karam , Noha Al Hachem
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摘要

钩端螺旋体病是一种由致病性钩端螺旋体引起的世界性人畜共患疾病。它通常表现为一种急性细菌性发热败血症样疾病,可影响人和动物。人感染可通过粘膜表面、擦伤的皮肤或吸入被污染的雾化水发生。肝受累是钩端螺旋体病的常见发现,范围从轻度功能障碍到严重黄疸疾病伴肾功能衰竭。我们在此报告一例由钩端螺旋体病引起的急性肝炎和发热性黄疸。患者有心脏受累,但没有肺或肾受累,进一步增加了诊断的模糊性。由于其不典型的表现,该病例的钩端螺旋体病的诊断特别具有挑战性。这些不寻常的发现强调了在发热性黄疸的鉴别诊断中考虑钩端螺旋体病的重要性,即使在没有经典危险因素的情况下。开始可能挽救生命的抗生素治疗需要高度的临床怀疑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A-not-full-blown Weil’s disease: An atypical cause of leptospirosis-induced acute hepatitis
Leptospirosis is a worldwide zoonotic disease caused by pathogenic Leptospira species. It usually manifests as an acute bacterial febrile septicemia like illness that affects both humans and animals. Human infection may occur via mucosal surfaces, abraded skin, or inhalation of aerosolized contaminated water. Liver involvement is a frequent finding in leptospirosis that ranges from mild dysfunction to severe icteric illness with renal failure. We herein present a case of acute hepatitis and febrile jaundice induced by Leptospirosis. The patient had cardiac involvement but no pulmonary or renal involvement, further adding ambiguity to the diagnosis. The diagnosis of leptospirosis in this case was particularly challenging due to its atypical presentation. The unusual constellation of findings underscores the importance of considering leptospirosis in the differential diagnosis of febrile jaundice, even in the absence of classical risk factors. The initiation of potentially life-saving antibiotic treatment requires a high index of clinical suspicion.
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