Q 热伴结节性红斑 1 例
A case of Q fever with erythema nodosum.
机构信息
Department of Internal Medicine, Centre hospitalier universitaire de Poitiers, 2 Rue de la milétrie, 86000, Poitiers, France.
Department of infectious diseases, Centre hospitalier universitaire de Poitiers, 2 Rue de la milétrie, 86000, Poitiers, France.
出版信息
Infection. 2018 Feb;46(1):127-129. doi: 10.1007/s15010-017-1058-4. Epub 2017 Aug 17.
BACKGROUND
Acute Q fever is asymptomatic in 60% of the patients, while the reminder may present with fever, pneumoniae, and hepatitis. Skin manifestations are uncommon including transient punctiform rashes, purpuric, or maculopapular eruptions. Erythema nodosum have seldom been reported.
CASE PRESENTATION
A 37-year-old female presented with fever for 1 month and skin lesions consists of erythematous painful nodule of the legs. Serological testing for Coxiella burnetii was positive. Treatment consisted with doxycycline for 2 weeks. Evolution was favorable. The patient completely recovered and had no evidence of skin lesion 1 month later.
CONCLUSION
Because of its nonspecific clinical presentation, Q fever with erythema nodosum is probably underestimated. Q fever should be evocated when facing unexplained erythema nodosum even if there is not other typical clinical manifestation of Q fever.
背景
60%的急性 Q 热患者无症状，其余患者可能表现为发热、肺炎和肝炎。皮肤表现并不常见，包括一过性点状皮疹、紫癜性或斑丘疹。结节性红斑则很少见。
病例介绍
一名 37 岁女性因发热 1 个月就诊，下肢出现红斑性疼痛性结节。柯克斯体血清学检查阳性。治疗采用多西环素治疗 2 周。病情好转。1 个月后，患者完全康复，皮肤损伤无任何迹象。
结论
由于其非特异性临床表现，结节性红斑性 Q 热可能被低估。即使没有 Q 热的其他典型临床表现，当遇到不明原因的结节性红斑时，也应考虑 Q 热。
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