Maniam Akash, Ravichandran Sriram
ITU and Anaesthetics, Barnet Hospital, London, UK
Haematology, Barnet Hospital, London, UK.
BMJ Case Rep. 2017 Mar 25;2017:bcr-2017-219510. doi: 10.1136/bcr-2017-219510.
A young man presented to accident and emergency with a short history of diarrhoea and vomiting, with no medical history. He deteriorated rapidly during triage and never regained consciousness. He was pronounced dead after hours of attempted resuscitation. He was found to have organisms suggestive of diplococci on his blood film and subsequently had MenY found via PCR testing. This case illustrates a highly unusual presentation of invasive meningococcal disease caused by MenY which is quietly and dangerously increasing in incidence in the UK, particularly in young healthy patients. All clinicians are reminded to be vigilant in order to diagnose and treat this often fatal disease as well as to promote uptake of the quadrivalent MenACWY vaccine.
一名年轻男子因腹泻和呕吐病史较短且无既往病史前往急诊室。他在分诊期间迅速恶化,再也没有恢复意识。经过数小时的复苏尝试后,他被宣布死亡。在他的血涂片上发现了提示双球菌的微生物,随后通过聚合酶链反应检测发现了Y群脑膜炎奈瑟菌。该病例说明了由Y群脑膜炎奈瑟菌引起的侵袭性脑膜炎球菌病的一种非常不寻常的表现,这种疾病在英国的发病率正在悄然且危险地上升,尤其是在年轻健康患者中。提醒所有临床医生要保持警惕,以便诊断和治疗这种往往致命的疾病,并促进四价ACWY群脑膜炎球菌疫苗的接种。