Laboratory Department, the First People's Hospital of Tianmen City, Tianmen, 431700, Hubei, China.
Gastrology department, the First People's Hospital of Tianmen City, Tianmen, 431700, Hubei, China.
BMC Microbiol. 2021 Oct 5;21(1):270. doi: 10.1186/s12866-021-02323-x.
Rickettsia is the pathogen of Q fever, Brucella ovis is the pathogen of brucellosis, and both of them are Gram-negative bacteria which are parasitic in cells. The mixed infection of rickettsia and Brucella ovis is rarely reported in clinic. Early diagnosis and treatment are of great significance to the treatment and prognosis of brucellosis and Q fever. Here, we report a case of co-infection Rickettsia burneti and Brucella melitensis. The patient is a 49-year-old sheepherder, who was hospitalized with left forearm trauma. Three days after admission, the patient developed fever of 39.0°C, accompanied by sweating, fatigue, poor appetite and headache. Indirect immunofluorescence (IFA) was used to detect Rickettsia burneti IgM. After 72 hours of blood culture incubation, bacterial growth was detected in aerobic bottles, Gram-negative bacilli were found in culture medium smear, the colony was identified as Brucella melitensis by mass spectrometry. Patients were treated with doxycycline (100 mg bid, po) and rifampicin (600 mg qd, po) for 4 weeks. After treatment, the symptoms disappeared quickly, and there was no sign of recurrence or chronic infection. Q fever and Brucella may exist in high-risk practitioners, so we should routinely detect these two pathogens to prevent missed diagnosis.
立克次体是 Q 热的病原体，绵羊布鲁氏菌是布鲁氏菌病的病原体，两者均为寄生在细胞内的革兰氏阴性菌。临床很少报道立克次体和绵羊布鲁氏菌的混合感染。早期诊断和治疗对布鲁氏菌病和 Q 热的治疗和预后具有重要意义。本研究报告了一例贝氏柯克斯体和马耳他布鲁氏菌合并感染病例。患者为 49 岁牧羊人，因左前臂外伤入院。入院后 3 天，患者出现 39.0°C 发热，伴有出汗、乏力、食欲差和头痛。采用间接免疫荧光法（IFA）检测贝氏柯克斯体 IgM。血培养孵育 72 小时后，在需氧瓶中检测到细菌生长，培养物涂片发现革兰氏阴性杆菌，通过质谱鉴定为马耳他布鲁氏菌。患者接受多西环素（100 mg bid，po）和利福平（600 mg qd，po）治疗 4 周。治疗后，症状迅速消失，无复发或慢性感染迹象。Q 热和布鲁氏菌可能存在于高危从业者中，因此我们应常规检测这两种病原体，以防漏诊。
