印度奥里萨邦一家三级护理医院急性脑炎综合征中钩端螺旋体病和丛林斑疹伤寒的关联。
Association of leptospirosis and scrub typhus in acute encephalitis syndrome in a tertiary care hospital in Odisha, India.
机构信息
Department of Medicine, SCB Medical College & Hospital, Manglabag, Cuttack 753007, Odisha, India.
ICMR-Regional Medical Research Centre, Bhubaneswar 751023, Odisha, India.
出版信息
Trans R Soc Trop Med Hyg. 2021 Sep 3;115(9):1088-1090. doi: 10.1093/trstmh/trab063.
BACKGROUND
Acute encephalitis syndrome (AES) is a major public health concern in India, causing febrile illness principally associated with viral infection. Bacteria-like scrub typhus and leptospirosis also cause acute febrile illness. Therefore, this study was conceived to address the possible etiological agents contributing to sporadic AES in a tertiary care center in Odisha, India.
METHOD
This was a prospective hospital-based study that enrolled 92 consecutive patients with clinically diagnosed AES whose blood/cerebrospinal fluid samples were tested for IgM antibodies to dengue, Japanese encephalitis (JE), herpes simplex virus (HSV), Epstein-Barr virus (EBV), leptospirosis and scrub typhus.
RESULTS
Viral antibodies to dengue were detected in three (3.26%) cases, HSV1 in four (4.34%) and HSV2 in three (3.26%) cases. Significantly, antibodies to EBV in 22 (23.591%) and to JE in 27 (29.34%) cases were detected. Notably, 30 (32.60%) and 11(12.0%) of patients had IgM antibodies to leptospirosis and scrub typhus, respectively.
CONCLUSION
This observation indicates an association of leptospirosis and scrub typhus infection in sporadic cases of AES, besides other viruses.
背景
急性脑炎综合征（AES）是印度的一个主要公共卫生关注点，主要由病毒感染引起发热性疾病。细菌样恙虫病和钩端螺旋体病也会引起急性发热性疾病。因此，这项研究旨在探讨在印度奥里萨邦的一家三级护理中心，散发性 AES 的可能病因。
方法
这是一项前瞻性的基于医院的研究，纳入了 92 例连续就诊的临床诊断 AES 患者，对其血液/脑脊液样本进行了登革热、日本脑炎（JE）、单纯疱疹病毒（HSV）、爱泼斯坦-巴尔病毒（EBV）、钩端螺旋体病和恙虫病的 IgM 抗体检测。
结果
三例（3.26%）患者检测到登革热病毒抗体，四例（4.34%）患者检测到 HSV1 抗体，三例（3.26%）患者检测到 HSV2 抗体。值得注意的是，22 例（23.591%）患者和 27 例（29.34%）患者检测到 EBV 抗体和 JE 抗体。此外，30 例（32.60%）和 11 例（12.0%）患者分别存在针对钩端螺旋体病和恙虫病的 IgM 抗体。
结论
除其他病毒外，本观察结果表明，在 AES 的散发病例中，存在钩端螺旋体病和恙虫病感染的关联。
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