Seow Christopher Wen-Xing, Logarajah Veena, Tan Natalie Woon Hui
KK Women's and Children's Hospital, Singapore, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Glob Pediatr Health. 2017 Aug 25;4:2333794X17726941. doi: 10.1177/2333794X17726941. eCollection 2017.
This is a case report of a 12-year-old returned traveler with typhoid and scrub typhus coinfection. The diagnosis of typhoid was made early with blood cultures and Widal Weil Felix serology. Persistent fever despite appropriate antibiotics for typhoid fever prompted a search for concomitant infection, which led to the diagnosis of scrub typhus confirmed by serology. The patient was given doxycycline with good clinical response. Scrub typhus infection should be an early consideration in the differential diagnoses of fever in a returned traveler from regions where it is endemic. Coinfections should be taken into consideration particularly when fever or symptoms persist despite adequate therapy for a previously identified microorganism.
这是一例12岁归国旅行者伤寒与恙虫病合并感染的病例报告。通过血培养和肥达-外斐血清学检查早期诊断出伤寒。尽管使用了针对伤寒热的适当抗生素，但持续发热促使对合并感染进行排查，血清学检查确诊为恙虫病。患者接受多西环素治疗后临床反应良好。对于来自恙虫病流行地区的归国旅行者，在发热的鉴别诊断中应尽早考虑恙虫病感染。特别是当针对先前确定的微生物进行充分治疗后仍持续发热或有症状时，应考虑合并感染的情况。
