揭示罕见诊断疾病:斯洛伐克严重钩端螺旋体病多器官衰竭

IF 2.1 Q3 MICROBIOLOGY Microbiology Research Pub Date : 2023-09-27 DOI:10.3390/microbiolres14040104
Ondrej Zahornacky, Štefan Porubčin, Alena Rovňáková, Ján Fedačko, Pavol Jarčuška
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引用次数: 0

摘要

钩端螺旋体病是一种由钩端螺旋体属细菌引起的人畜共患疾病。这种感染主要发生在热带地区的发展中国家和卫生标准较低的国家。在有啮齿类动物(主要是大鼠)存在的环境中,发病率最高,这是一种潜在的感染源。钩端螺旋体病的临床表现和严重程度变化很大。本病例报告描述了一名无合并症的53岁患者(男性),他因黄疸、全身疲劳、虚弱和发烧(在家大约7天的健康困难)住进斯洛伐克东部的传染病科。该患者的临床实验室表现以明显的高胆红素血症、急性肾功能衰竭、肝病、严重的血小板减少、胸片表现为双侧间质性肺炎的肺实质受累为主。双联合抗生素(头孢曲松和克拉霉素)加入治疗。住院期间,根据病史和实验室检查结果怀疑诊断为钩端螺旋体病,随后经血清学证实。抗生素方案降级为头孢菌素(头孢曲松)单药治疗,有足够的实验室和临床效果(第4天)。患者于18天后出院,临床情况良好。
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Uncovering a Rarely Diagnosed Disease: Severe Leptospirosis with Multiorgan Failure in Slovakia
Leptospirosis is a zoonotic disease caused by bacteria from the genus Leptospira. The infection occurs mainly in developing countries in the tropical zone and countries with lower hygiene standards. The highest incidence is observed especially in environments associated with the presence of rodents, mainly rats, which are a potential source of infection. The clinical manifestations and severity of leptospirosis are highly variable. This case report describes the a 53-year-old patient (male) without comorbidities, who was admitted to an infectious disease department in the east of Slovakia for jaundice, general fatigue, weakness, and fever (health difficulties for approximately 7 days at home). The clinical laboratory picture of the patient was dominated by significant hyperbilirubinemia, acute renal failure, hepatopathy, severe thrombocytopenia, and involvement of the lung parenchyma in the sense of bilateral interstitial pneumonia on chest X-ray. A double combination of antibiotics (ceftriaxone and clarithromycin) were added to the treatment. During hospitalization, a diagnosis of leptospirosis was suspected based on medical history and the results of laboratory tests and was subsequently confirmed serologically. The antibiotic regimen was de-escalated to cephalosporin (ceftriaxone) monotherapy with adequate laboratory and clinical effects (on the 4th day). The patient was discharged after a total of 18 days in good clinical condition.
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来源期刊
Microbiology Research
Microbiology Research MICROBIOLOGY-
CiteScore
1.90
自引率
6.70%
发文量
62
审稿时长
10 weeks
期刊介绍: Microbiology Research is an international, online-only, open access peer-reviewed journal which publishes original research, review articles, editorials, perspectives, case reports and brief reports to benefit researchers, microbiologists, physicians, veterinarians. Microbiology Research publishes ‘Clinic’ and ‘Research’ papers divided into two different skill and proficiency levels: ‘Junior’ and ‘Professional’. The aim of this four quadrant grid is to encourage younger researchers, physicians and veterinarians to submit their results even if their studies encompass just a limited set of observations or rely on basic statistical approach, yet upholding the customary sound approach of every scientific article.
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