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埃立克体病——一种在波兰很少被认识到的疾病

[Ehrlichiosis--a disease rarely recognized in Poland].

作者信息

Grygorczuk Sambor, Hermanowska-Szpakowicz Teresa, Kondrusik Maciej, Pancewicz Sławomir, Zajkowska Joanna

机构信息

Kliniki Chorób Zakaźnych i Neuroinfekcji, Akademii Medycznej w Białymstoku, Wojewódzki Szpital Specjalistyczny.

出版信息

Wiad Lek. 2004;57(9-10):456-61.

Abstract

Ehrlichioses constitute a group of acute zoonoses caused by the infection with the microorganisms belonging to the genera Ehrlichia, Anaplasma and Neorickettsia (Rickettsiaceae). Presence of human granulocytic ehrlichiosis (HGE) caused by infection with Anaplasma phagocytophila (A. phagocytophila) and transmitted by Ixodes ricinus tick has been confirmed in Poland. All the cases described so far were noted in the area of endemic prevalence of Lyme borreliosis (north-east of Poland). Lack of characteristic symptoms makes the diagnosis of HGE difficult. It should be suspected in patients exposed to tick bites during the preceding few weeks, in whom acute, febrile illness accompanied by leucopenia and thrombocytopenia develops. The course of infection may be serious, or even life-threatening, in patients more than 40 years old; consequences of co-infection with A. phagocytophila and other tick-borne pathogens remain not well known. There is probably no risk of the development of chronic HGE. As specific diagnostic methods are not widely accessible in Poland, empirical therapy with doxycycline may be of benefit in suspected HGE cases.

摘要

埃立克体病是由感染埃立克体属、无形体属和新立克次体属(立克次体科)的微生物引起的一组急性人畜共患病。在波兰已证实存在由嗜吞噬细胞无形体(A. phagocytophila)感染引起并由蓖麻硬蜱传播的人类粒细胞埃立克体病(HGE)。迄今为止描述的所有病例均出现在莱姆病的地方流行区(波兰东北部)。缺乏特征性症状使得HGE的诊断困难。在前几周有蜱叮咬史、出现伴有白细胞减少和血小板减少的急性发热性疾病的患者应怀疑患有此病。对于40岁以上的患者,感染过程可能很严重,甚至危及生命;与嗜吞噬细胞无形体和其他蜱传播病原体共同感染的后果仍不为人所知。可能不存在慢性HGE发展的风险。由于波兰没有广泛可用的特异性诊断方法,对于疑似HGE病例,使用强力霉素进行经验性治疗可能有益。

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