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佛罗里达州出现的一例以韦尔氏病形式表现的散发性钩端螺旋体病病例。

Sporadic leptospirosis case in Florida presenting as Weil`s disease.

作者信息

Bini Viotti Julia, Chan Joseph C, Rivera Cynthia, Tuda Claudio

机构信息

Department of Medicine, Mount Sinai Medical Center, Miami Beach, FL, USA.

Department of Infectious Diseases, Mount Sinai Medical Center, Miami Beach, FL, USA.

出版信息

IDCases. 2019 Dec 19;19:e00686. doi: 10.1016/j.idcr.2019.e00686. eCollection 2020.

Abstract

Leptospirosis has been rarely reported in the United States and has been historically related to occupational exposure to infected animals, and contaminated environments. Over the past decade, there are indications that at-risk populations may be changing in the United States, to also include participants in freshwater sports and occasionally individuals living in economically disadvantaged urban inner- city environments. We present a case of Weil`s disease in a 39-year-old homeless man who had been released from prison two weeks prior and denied direct contact with infected animals or contaminated fresh water. Prison inmates and homeless patients are potentially at high risk of rat exposure and infection with . A high index of suspicion is needed for diagnosis of leptospirosis in the absence of traditional risk factors. To our knowledge, this is the first case of leptospirosis associated with homelessness and incarceration in the United States. A literature review on leptospirosis cases in Florida over the past 60 years was performed.

摘要

钩端螺旋体病在美国鲜有报道,历史上一直与职业性接触受感染动物及受污染环境有关。在过去十年间,有迹象表明美国的高危人群可能正在发生变化,还包括淡水运动参与者以及偶尔居住在经济弱势城市内城环境中的个体。我们报告一例韦尔氏病病例,患者为一名39岁的无家可归男子,两周前刚从监狱获释,否认与受感染动物或受污染淡水有直接接触。监狱囚犯和无家可归患者有接触老鼠并感染钩端螺旋体的潜在高风险。在缺乏传统风险因素的情况下,诊断钩端螺旋体病需要高度怀疑。据我们所知,这是美国首例与无家可归和监禁相关的钩端螺旋体病病例。我们对佛罗里达州过去60年的钩端螺旋体病病例进行了文献综述。

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