Moskovitz M, Fadden R, Min T
Department of Internal Medicine, Gastroenterology, Medical Center, Beaver, PA 15009.
J Clin Gastroenterol. 1991 Feb;13(1):86-90.
We report an unusual case of a typically canine rickettsial disease, ehrlichiosis, in a 56-year-old man. Although only occasionally affecting humans with a mild illness, exposure to a tick bite in our patient led to severe multisystemic disease with intense cholestasis. Coma, acute renal failure and respiratory failure requiring mechanical ventilation ensued. Imaging procedures showed no biliary obstruction. A liver biopsy demonstrated bile stasis and sinusoidal lymphoid infiltrates. The diagnosis was confirmed serologically. Only partial improvement occurred with tetracycline therapy, but total resolution of all abnormalities eventually followed therapy with chloramphenicol.
我们报告了一例不同寻常的病例，一名56岁男性感染了典型的犬类立克次体病——埃立克体病。虽然这种疾病仅偶尔感染人类且病情较轻，但我们的患者因被蜱虫叮咬而引发了严重的多系统疾病，并伴有严重的胆汁淤积。随后出现昏迷、急性肾衰竭和需要机械通气的呼吸衰竭。影像学检查未显示胆道梗阻。肝脏活检显示胆汁淤积和窦状隙淋巴细胞浸润。血清学检查确诊了该疾病。四环素治疗仅带来部分改善，但氯霉素治疗最终使所有异常完全消失。
