34岁孕妇再次感染水痘

Somayeh Karimi, Sepideh Babaniamansour, Ehsan Aliniagerdroudbari
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摘要

一名34岁孕妇被转介到我们的急诊科,她抱怨6天前开始的皮肤病变加剧。最初,水疱性病变始于头部和面部,并伴有发热,在4天内转变为全身范围的脓疱性病变(图1)。通过调查患者的个人接触史,我们发现在入院前19天,她9岁的孩子也出现了同样的症状,诊断为水痘。患者在7岁时也曾有过水痘感染史。患者患病但无毒,意识清醒,血压98/59 mmHg,呼吸频率18次/分钟,心率100次/分钟,体检口腔体温37.2℃。患者无呼吸窘迫、呼吸困难、脑膜症状(Kernig征、Brudzinksi征和颈部强直)、共济失调或感觉缺陷,其他体格检查均正常。确诊为水痘后,静脉注射阿昔洛韦750 mg,每日3次,同时静脉注射克林霉素900 mg TDS,并联合静脉输液,最终患者住进传染病病房。
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A 34-year-old Pregnant Woman with Chickenpox Re-infection
A 34-year-old pregnant woman was referred to our emergency ward, complaining of intensification of skin lesions which had started six days earlier. Initially, vesicular lesions had started from head and face accompanied by fever which turn to generalized pustular lesions expanded to the whole body within four days (figure 1). By investigating the patient's personal contact history, we found that same symptoms were detected in her 9-year-old child 19 days prior to admission which was diagnosed as chickenpox. The patient also had mentioned previous history of chicken pox infection at her age of seven. She was ill but not toxic and was conscious with a blood pressure of 98/59 mmHg, respiratory rate of 18 breaths per minute, heart rate of 100 beats per minute and oral temperature of 37.2 °C in physical examination. She didn't have respiratory distress, dyspnea, meningism symptoms (Kernig Sign, Brudzinksi, and Nuchal Rigidity), ataxia or sensory defect and her all other physical examinations were normal. Upon diagnosis of chickenpox, intravenous (IV) acyclovir 750 mg three times a day and also IV clindamycin 900 mg TDS in combination with IV fluid were administered and finally the patient was admitted in Infectious diseases ward.
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