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热带感染诱发围产期暴发性肝炎成功治愈:命运的故事

Tropical Infections Induced Fulminant Hepatitis in Peripartum Managed Successfully: Tales of Fate.

作者信息

Tayade Surekha, Madaan Sparsh, Kumar Sunil, Talwar Dhruv, Chadha Arzoo

机构信息

Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, IND.

Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, IND.

出版信息

Cureus. 2022 Feb 15;14(2):e22223. doi: 10.7759/cureus.22223. eCollection 2022 Feb.

Abstract

Tropical diseases such as malaria, dengue, intestinal helminths, schistosomiasis, leishmaniasis, and filariasis have an essential influence on the reproductive health of patients. Various cases of pregnancy loss in unexplained circumstances are a result of underdiagnosed tropical diseases. Term pregnancy complicated by tropical diseases is a challenge for the treating clinicians as these infections tend to mimic HELLP (Hemolysis, Elevated Liver enzymes, and Low Platelets) syndrome and increase the chances of perinatal complications and maternal mortality. Except for tropical diseases, ever since the conception of the COVID-19 pandemic, the differentials for fever pregnancy have become extensive, and the treating clinicians need to solve the puzzle of the etiology behind these symptoms that are non-specific and might be due to both COVID-19 and tropical Infections. Prophylactic treatment for malaria is pivotal in pregnancy as immunity is decreased during pregnancy, making the patient susceptible to developing malaria-related complications. Dengue is one of the most common mosquito-borne infections found around the globe. Complications of dengue during pregnancy include pregnancy loss as well as vertical transmission of infection to the fetus. Leptospirosis, even though rare, has a wide range of complications in pregnancy ranging from fetal loss to congenital infection and oligohydramnios, thereby requiring close monitoring and prompt management during pregnancy. We report a case series of three cases where patients presented during the period of pregnancy with fulminant hepatic failure, which turned out to be a consequence of tropical diseases. All the cases were treated successfully and discharged in stable condition.

摘要

疟疾、登革热、肠道寄生虫病、血吸虫病、利什曼病和丝虫病等热带疾病对患者的生殖健康有着至关重要的影响。在不明原因的各种流产病例中,热带疾病诊断不足是其原因之一。妊娠合并热带疾病对治疗临床医生来说是一项挑战,因为这些感染往往会模仿 HELLP(溶血、肝酶升高和血小板减少)综合征,并增加围产期并发症和孕产妇死亡率的几率。除了热带疾病,自新冠疫情出现以来,孕期发热的鉴别诊断范围变得更广,治疗临床医生需要解开这些非特异性症状背后病因的谜团,这些症状可能是由新冠病毒和热带感染共同导致的。孕期疟疾的预防性治疗至关重要,因为孕期免疫力会下降,使患者易患与疟疾相关的并发症。登革热是全球最常见的蚊媒感染之一。孕期登革热的并发症包括流产以及感染垂直传播给胎儿。钩端螺旋体病虽然罕见,但在孕期会引发广泛的并发症,从胎儿丢失到先天性感染和羊水过少,因此在孕期需要密切监测并及时处理。我们报告了一组三例病例,这些患者在孕期出现暴发性肝衰竭,结果发现是热带疾病所致。所有病例均成功治疗并在病情稳定后出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6409/8928236/0c4de77c0ed0/cureus-0014-00000022223-i01.jpg

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