School of Medicine, Shihezi University, Shihezi, 832002, Xinjiang Uygur Autonomous Region, China.
The First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, 832002, Xinjiang Uygur Autonomous Region, China.
BMC Infect Dis. 2021 Nov 25;21(1):1187. doi: 10.1186/s12879-021-06877-z.
Increasing numbers of tick-borne pathogens are being discovered, including those that infect humans. However, reports on co-infections caused by two or more tick-borne pathogens are scarce.
A 38-year-old male farmer was bitten by a hard tick, presented with fever (37.7 °C), severe headache and ejection vomiting. Lumbar puncture was performed in the lateral decubitus. The cerebrospinal fluid (CSF) was clear, and analysis showed severe increased pressure (320 mm HO), mild leukocytosis (126.0 × 10/L, mononuclear cells accounting for 73%) and elevated total protein concentration (0.92 g/L). Bacterial cultures of CSF and blood were negative. The diagnosis of Rickettsia raoultii and Tacheng tick virus 1 (TcTV-1) co-infection was confirmed by amplifying four rickettsial genetic markers and the partial small (S) RNA segment of TcTV-1 from the patient's blood. The patient gradually recovered after treatment with levofloxacin and ribavirin.
This is the first reported co-infection case with fever and meningitis caused by R. raoultii and TcTV-1. It is vital to screen for multiple pathogens in tick-bitten patients, especially in those with severe complex symptoms.
越来越多的蜱传病原体被发现，包括感染人类的病原体。然而，关于两种或多种蜱传病原体引起的合并感染的报告很少。
一名 38 岁男性农民被硬蜱叮咬，出现发热（37.7°C）、剧烈头痛和喷射性呕吐。行侧卧位腰椎穿刺。脑脊液（CSF）清亮，分析显示严重高颅压（320mmH2O）、轻度白细胞增多（126.0×10/L，单核细胞占 73%）和总蛋白浓度升高（0.92g/L）。CSF 和血液的细菌培养均为阴性。通过从患者血液中扩增四个立克次体遗传标记物和塔城蜱病毒 1（TcTV-1）的部分小（S）RNA 片段，确诊为拉乌尔菌和塔城蜱病毒 1（TcTV-1）合并感染。患者经左氧氟沙星和利巴韦林治疗后逐渐康复。
这是首例报告的由拉乌尔菌和塔城蜱病毒 1（TcTV-1）引起的发热性脑膜炎合并感染病例。对蜱虫叮咬患者，特别是有严重复杂症状的患者，进行多种病原体筛查至关重要。
