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布鲁氏菌感染患者发生的血栓性血小板减少性紫癜对联合血浆输注和抗菌治疗反应良好。

Thrombotic thrombocytopenic purpura in a patient with Brucella infection is highly responsive to combined plasma infusion and antimicrobial therapy.

作者信息

Erdem Fuat, Kiki Ilhami, Gundoğdu Mehmet, Kaya Hasan

机构信息

Department of Internal Medicine, Division of Hematology, School of Medicine, University of Ataturk, Erzurum, Turkey.

出版信息

Med Princ Pract. 2007;16(4):324-6. doi: 10.1159/000102159.

Abstract

OBJECTIVE

To report a case of brucella infection presenting with thrombotic thrombocytopenic purpura (TTP) that responded well to plasma and antimicrobial treatment infusion.

CASE PRESENTATION AND INTERVENTION

A 51-year-old man with moderate confusion, depressed mood and dysarthria was admitted. He was chronically ill, with fever (38.5 degrees C), anemia, jaundice and petechial-purpuric skin lesions. Neurological examination revealed diminished consciousness with a Glasgow coma scale score of 7 and +1 neck rigidity. The hemoglobin and platelet counts were decreased and reticulocyte index, erythrocyte sedimentation rate, as well as serum lactate dehydrogenase and renal dysfunction were elevated. TTP was a possible diagnosis and the patient responded well to plasma infusion and antimicrobial treatment.

CONCLUSION

This report shows that therapy of underlying infection together with plasma infusion may be a successful treatment option for brucellosis-induced TTP.

摘要

目的

报告一例布鲁氏菌感染并发血栓性血小板减少性紫癜(TTP)的病例,该病例对血浆输注和抗菌治疗反应良好。

病例介绍与干预

一名51岁男性因中度意识模糊、情绪低落和构音障碍入院。他患有慢性病,伴有发热(38.5摄氏度)、贫血、黄疸和瘀点瘀斑性皮肤损害。神经系统检查显示意识减退,格拉斯哥昏迷量表评分为7分,颈部强直为+1级。血红蛋白和血小板计数降低,网织红细胞指数、红细胞沉降率以及血清乳酸脱氢酶升高且存在肾功能不全。TTP为可能的诊断,患者对血浆输注和抗菌治疗反应良好。

结论

本报告表明,针对潜在感染进行治疗并联合血浆输注可能是治疗布鲁氏菌病所致TTP的成功治疗方案。

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