Guarner J, Shieh W J, Morgan J, Bragg S L, Bajani M D, Tappero J W, Zaki S R
Infectious Disease Pathology Activity, Division of Viral and Rickettsial Diseases, and Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Hum Pathol. 2001 Jul;32(7):750-2. doi: 10.1053/hupa.2001.25599.
Leptospirosis, a disease acquired by exposure to contaminated water, is characterized by fever accompanied by various symptoms, including abdominal pain. An acute febrile illness occurred in athletes who participated in an Illinois triathlon in which the swimming event took place in a freshwater lake. Of 876 athletes, 120 sought medical care and 22 were hospitalized. Two of the athletes had their gallbladders removed because of abdominal pain and clinical suspicion of acute cholecystitis. We applied an immunohistochemical test for leptospirosis to these gallbladders and demonstrated bacterial antigens staining (granular and filamentous patterns) around blood vessels of the serosa and muscle layer. Rare intact bacteria were seen in 1 case. These results show that leptospirosis can mimic the clinical symptoms of acute cholecystitis. If a cholecystectomy is performed in febrile patients with suspicious environmental or animal exposure, pathologic studies for leptospirosis on formalin-fixed, paraffin-embedded tissues may be of great value.
钩端螺旋体病是一种因接触受污染的水而感染的疾病，其特征为发热并伴有包括腹痛在内的各种症状。在伊利诺伊州一场铁人三项赛中，参加游泳项目的运动员在一个淡水湖中进行比赛后出现了急性发热性疾病。876名运动员中，有120人寻求医疗护理，22人住院治疗。两名运动员因腹痛且临床怀疑为急性胆囊炎而接受了胆囊切除术。我们对这些切除的胆囊进行了钩端螺旋体病免疫组织化学检测，结果显示在浆膜和肌肉层血管周围有细菌抗原染色（颗粒状和丝状模式）。1例中可见罕见的完整细菌。这些结果表明，钩端螺旋体病可模拟急性胆囊炎的临床症状。对于有可疑环境或动物接触史的发热患者进行胆囊切除术时，对福尔马林固定、石蜡包埋组织进行钩端螺旋体病的病理研究可能具有重要价值。
