Department of Internal Medicine, Providence Health and Services Oregon and Southwest Washington, Portland, Oregon, USA
Department of Internal Medicine, Providence Health and Services Oregon and Southwest Washington, Portland, Oregon, USA.
BMJ Case Rep. 2021 Apr 16;14(4):e241004. doi: 10.1136/bcr-2020-241004.
A 70-year-old man presented to the emergency department with fevers, ankle edema and nausea following a presumed insect bite on his ankle 1 month prior. On examination, he was febrile and had left leg pain with passive range of motion. Laboratory studies revealed anemia, thrombocytopenia, acute kidney injury and elevated aminotransaminases. Due to his recent travel to the Northeastern United States, he was suspected of having a possible tick-borne illness. Serologies were positive for , and , and the patient was diagnosed with Lyme disease, babesiosis and anaplasmosis. He was treated with doxycyline, atovaquone and azithromycin, leading to resolution of symptoms. While co-infection with Lyme disease is common, infection with three tickborne illnesses at one time is relatively rare.
一位 70 岁男性，1 个月前因踝关节疑似虫咬而出现发热、踝关节肿胀和恶心，随后到急诊科就诊。体格检查发现他发热，左腿疼痛且被动活动范围受限。实验室研究显示贫血、血小板减少、急性肾损伤和氨基转移酶升高。由于他最近前往美国东北部旅行，因此怀疑他可能患有蜱传疾病。血清学检查结果显示 、 和 阳性，患者被诊断为莱姆病、巴贝斯虫病和无形体病。他接受了多西环素、阿托伐醌和阿奇霉素治疗，症状得到缓解。虽然莱姆病的合并感染很常见，但一次感染三种蜱传疾病相对较少见。
