汉坦病毒感染和钩端螺旋体病的临床和生化差异:对比利时患者系列的回顾性分析。

IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Acta Clinica Belgica Pub Date : 2020-06-01 Epub Date: 2019-03-18 DOI:10.1080/17843286.2019.1591654
Emma Bakelants, Willy Peetermans, Katrien Lagrou, Wouter Meersseman
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引用次数: 4

摘要

目的:汉坦病毒感染和钩端螺旋体病是由啮齿动物传播的传染病。临床表现无特异性,常累及肾脏,但也可累及其他器官。临床和生化的线索,使这两个实体之间的区别将被描述。方法:对2012年1月至2017年9月在比利时鲁汶大学医院急诊科就诊的患者数据库进行回顾性分析。患者的选择是基于相容的临床表现、生物化学和微生物学证据。比较两组患者的主诉和临床检查结果。就诊时取血,用于血液学和生化分析。结果:共检出汉坦病毒感染16例,钩端螺旋体病8例。所有病人都有全身不适和发热。其他常见的症状还有肌痛和头痛。钩端螺旋体病患者通常有恐光症或恐声症。寻找颈部僵硬和眼部病变可能有助于诊断钩端螺旋体病。可以识别病毒性和细菌性疾病在生物化学上的差异;高c反应蛋白(CRP)和白细胞左移倾向于钩端螺旋体病,乳酸脱氢酶(LDH)升高倾向于病毒感染。肝功能异常伴总胆红素升高常见于钩端螺旋体病。结论:本研究显示了一些微妙的线索,可能有助于区分汉坦病毒感染和钩端螺旋体病的患者呈现到医院在世界非流行地区。由于患者数量少,我们无法确定重要的临床或生化检查。血清学仍然是金标准。
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Clinical and biochemical differences between hantavirus infection and leptospirosis: a retrospective analysis of a patient series in Belgium.

Objectives: Hantavirus infection and leptospirosis are infectious diseases transmitted by rodents. The clinical picture is nonspecific, often involving the kidneys but other organs can be affected too. Clinical and biochemical clues to make a difference between these two entities will be described.Methods: A retrospective analysis was performed on a database of patients presenting between January 2012 and September 2017 at the emergency department of the university hospital Leuven, Belgium. Patients were selected on the basis of a compatible clinical picture, biochemistry, and microbiological evidence. Presenting complaints and clinical examination were compared. Blood, taken at presentation, was used for hematological and biochemical analysis.Results: Sixteen patients with hantavirus infection and eight patients with leptospirosis were identified. All patients complained about general malaise and fever. Other frequent complaints were myalgia and a headache. Patients with leptospirosis often experienced photo- or sonophobia.Looking for neck stiffness and eye lesions might help to diagnose leptospirosis.Differences in biochemistry between viral and bacterial disease could be recognized; high C-reactive protein (CRP) and leukocytosis with left shift favor leptospirosis, elevated lactate dehydrogenase (LDH) favors viral infection. Abnormal liver function with raised total bilirubin is often seen in cases with leptospirosis.Conclusion: This study demonstrates some subtle clues that may help to differentiate between hantavirus infection and leptospirosis in patients presenting to a hospital in a nonendemic region of the world. Because of small number of patients, we could not identify significant clinical or biochemical tests. Serology remains the gold standard.

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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
0.00%
发文量
44
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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