Yamashita Hiroshi, Furusu Akira, Nishino Tomoya, Obata Yoko, Miyazaki Masanobu, Ichinose Hiroshi, Higashiyama Yasuhito, Ishino Tohru, Koizumi Nobuo, Hirakata Yoichi, Kohno Shigeru
The Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Intern Med. 2010;49(12):1143-7. doi: 10.2169/internalmedicine.49.2920. Epub 2010 Jun 15.
In the autumn two patients with general malaise were consecutively admitted to the department of internal medicine of our hospital in the northern region of Nagasaki Prefecture. Since both patients were engaged in rice farm work and showed conjunctival suffusion and pain of the gastrocnemius muscle, leptospirosis was suspected. The first patient required temporary hemodialysis for renal dysfunction, whereas liver dysfunction developed in the second patient. The disease was remitted by antimicrobial agents. A diagnosis of leptospirosis was made serologically in both patients. Leptospirosis should be considered as a differential diagnosis when a patient engaged in farm work in the autumn has typical symptoms, and an early initiation of treatment after onset is important.
秋季，长崎县北部地区的我院内科连续收治了两名全身不适的患者。由于两名患者均从事稻田劳作，且出现结膜充血和腓肠肌疼痛，怀疑感染钩端螺旋体病。第一名患者因肾功能不全需要临时血液透析，而第二名患者出现肝功能障碍。使用抗菌药物后病情缓解。两名患者均通过血清学诊断为钩端螺旋体病。当秋季从事农业劳作的患者出现典型症状时，应考虑钩端螺旋体病作为鉴别诊断，发病后尽早开始治疗很重要。
