布鲁氏菌病的肺部受累。
Pulmonary involvement in brucellosis.
机构信息
Department of Infectious Diseases and Clinic Microbiology;
出版信息
Can J Infect Dis Med Microbiol. 2012 Spring;23(1):e13-5. doi: 10.1155/2012/164892.
BACKGROUND
Brucellosis is a zoonotic disease caused by a Gram-negative bacillus of the Brucella genus with multisystem involvement, primarily affecting the reticuloendothelial system, joints, heart and kidneys. Although the disease can be spread by inhalation, pulmonary involvement is rare.
OBJECTIVE
To report a case of brucellosis with pulmonary involvement. CASE PRESENTAION: A previously healthy 36-year-old woman was admitted with complaints of fever, weakness, night sweats, dry cough and bilateral chest pain. She hed been diagnosed with pneumonia 20 days previously and was started on a course of ampicillin for 14 days, with no response. Her chest auscultation revealed diminished breath sounds and scattered crackles and rhonchi over the inferior zone of the right hemithorax. Wright and Coombs testing resulted in titres of 1:1280 and 1:640, respectively. Chest radiography revealed an area of confluent lobar consolidation in the right lower lobe. Treatment was started with a six-week course of oral doxycycline 200 mg/day and rifampicin 600 mg/day. This treatment regimen rapidly improved the patient's condition. Follow-up after one year showed no residual effects from the infection.
CONCLUSION
Pulmonary involvement is a rare event in the course of brucellosis, but the rate could be higher than currently estimated. In endemic regions, brucellosis should be considered as a causative agent in patients with pulmonary symptoms.
BACKGROUND
Brucellosis is a zoonotic disease caused by a Gram-negative bacillus of the genus with multisystem involvement, primarily affecting the reticuloendothelial system, joints, heart and kidneys. Although the disease can be spread by inhalation, pulmonary involvement is rare.
OBJECTIVE
To report a case of brucellosis with pulmonary involvement.
CASE PRESENTAION
A previously healthy 36-year-old woman was admitted with complaints of fever, weakness, night sweats, dry cough and bilateral chest pain. She hed been diagnosed with pneumonia 20 days previously and was started on a course of ampicillin for 14 days, with no response. Her chest auscultation revealed diminished breath sounds and scattered crackles and rhonchi over the inferior zone of the right hemithorax. Wright and Coombs testing resulted in titres of 1:1280 and 1:640, respectively. Chest radiography revealed an area of confluent lobar consolidation in the right lower lobe. Treatment was started with a six-week course of oral doxycycline 200 mg/day and rifampicin 600 mg/day. This treatment regimen rapidly improved the patient’s condition. Follow-up after one year showed no residual effects from the infection.
CONCLUSION
Pulmonary involvement is a rare event in the course of brucellosis, but the rate could be higher than currently estimated. In endemic regions, brucellosis should be considered as a causative agent in patients with pulmonary symptoms.
背景
布鲁氏菌病是一种由布鲁氏菌属革兰氏阴性杆菌引起的动物源性疾病，可累及多个系统，主要影响网状内皮系统、关节、心脏和肾脏。尽管该疾病可通过吸入途径传播，但肺部受累较为罕见。
目的
报告一例布鲁氏菌病合并肺部受累病例。
病例介绍
一名 36 岁既往健康的女性因发热、乏力、盗汗、干咳和双侧胸痛而入院。她在 20 天前被诊断为肺炎，并接受了氨苄西林治疗 14 天，但无反应。胸部听诊显示右下肺呼吸音减弱，可闻及散在爆裂音和喘鸣音。Wright 和 Coombs 试验的滴度分别为 1:1280 和 1:640。胸部 X 线检查显示右下肺叶融合性大叶性实变。治疗开始给予 6 周疗程的口服多西环素 200mg/天和利福平 600mg/天。该治疗方案迅速改善了患者的病情。一年后随访未发现感染的残留影响。
结论
在布鲁氏菌病的病程中，肺部受累是一种罕见事件，但发生率可能高于目前估计。在流行地区，对于有肺部症状的患者，应考虑将布鲁氏菌病作为致病原因。
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