Phatharodom P, Limsrichamrern S, Kaewwinud J, Chayakulkeeree M
Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Transpl Infect Dis. 2015 Aug;17(4):574-8. doi: 10.1111/tid.12394. Epub 2015 Jun 15.
Zoonoses, especially rickettsial diseases, are rarely reported in solid organ transplant recipients. We report here a case of murine typhus in a 69-year-old liver transplant recipient, who presented with acute febrile illness 5 years post transplantation. Although receiving treatment with broad-spectrum antibiotics, he was still febrile and developed progressive dyspnea. Laboratory results showed elevated transaminases and his chest radiograph revealed bilateral interstitial infiltration. The diagnosis of murine typhus was made by a 4-fold rise in specific Rickettsia typhi antibody, using indirect immunofluorescent assay. He dramatically improved after treatment with doxycycline for 7 days. To our knowledge, this is the first case report of murine typhus in a liver transplant recipient.
人畜共患病，尤其是立克次体病，在实体器官移植受者中鲜有报道。我们在此报告一例69岁肝移植受者感染鼠型斑疹伤寒的病例，该患者在移植后5年出现急性发热性疾病。尽管接受了广谱抗生素治疗，但他仍持续发热并出现进行性呼吸困难。实验室检查结果显示转氨酶升高，胸部X光片显示双侧间质性浸润。通过间接免疫荧光法检测，特异性伤寒立克次体抗体呈4倍升高，从而确诊为鼠型斑疹伤寒。用强力霉素治疗7天后，他的病情显著改善。据我们所知，这是首例关于肝移植受者感染鼠型斑疹伤寒的病例报告。
