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病例报告:一名抑郁症患者患布鲁氏菌病并伴有罕见的多发性肺结节

Case report: Brucellosis with rare multiple pulmonary nodules in a depressed patient.

作者信息

Zhou Mingjing, Wang Ke, Liu Haoyuan, Ran Ran, Wang Xuan, Yang Yuqian, Han Qunying, Zhou Yi, Liu Xiaojing

机构信息

The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

出版信息

Front Med (Lausanne). 2023 Jan 17;9:1111830. doi: 10.3389/fmed.2022.1111830. eCollection 2022.

Abstract

BACKGROUND

Brucellosis is a zoonotic disease that threatens public health and creates an economic burden. Unfortunately, it is often overlooked in developing countries, with misdiagnosis causing negative impacts on those with low income. Although the symptoms of brucellosis are commonly reported as fever and fatigue, rare pulmonary, and psychiatric involvements should also be considered. We present the first brucellosis patient in China with multiple pulmonary nodules and depression. Furthermore, this report highlights the importance of collecting patient history in epidemic areas of brucellosis.

CASE PRESENTATION

We report the case of a 40-year-old woman with intermittent fever for 2 months and gradually accompanied by chills, dry cough, arthralgia, and fatigue. The patient was also diagnosed with depression after fever. She received symptomatic treatment at a regional hospital; however, there was no significant symptom relief. She suddenly developed hemoptysis 1 day prior to arrival at our hospital, where we discovered that her liver, spleen, neck, and axillary lymph nodes were enlarged, and there were multiple nodules in both lungs. The patient was eventually diagnosed with brucellosis after the serum agglutination test and received antibiotic therapy, which provided symptom relief.

CONCLUSION

This report describes a case of brucellosis with uncommon multipulmonary nodules and depression in China. This study has widened the evidence of respiratory involvement due to brucellosis. Second, it demonstrates the importance of collecting a comprehensive medical history, especially in epidemic areas. In conclusion, for febrile patients with pulmonary nodules and depression, especially in endemic areas, brucellosis should be considered.

摘要

背景

布鲁氏菌病是一种人畜共患病,威胁着公众健康并造成经济负担。不幸的是,在发展中国家它常常被忽视,误诊对低收入人群产生负面影响。虽然布鲁氏菌病的症状通常表现为发热和疲劳,但也应考虑罕见的肺部和精神方面的累及情况。我们报告了中国首例患有多发性肺结节和抑郁症的布鲁氏菌病患者。此外,本报告强调了在布鲁氏菌病流行地区收集患者病史的重要性。

病例介绍

我们报告了一名40岁女性的病例,她间歇性发热2个月,并逐渐伴有寒战、干咳、关节痛和疲劳。该患者在发热后还被诊断出患有抑郁症。她在当地一家医院接受了对症治疗;然而,症状没有明显缓解。在到达我院前1天,她突然出现咯血,我们发现她的肝脏、脾脏、颈部和腋窝淋巴结肿大,双肺有多个结节。该患者最终经血清凝集试验诊断为布鲁氏菌病,并接受了抗生素治疗,症状得到缓解。

结论

本报告描述了中国一例患有罕见的多发性肺结节和抑郁症的布鲁氏菌病病例。本研究拓宽了布鲁氏菌病导致肺部累及的证据。其次,它证明了收集全面病史的重要性,尤其是在流行地区。总之,对于有肺结节和抑郁症的发热患者,特别是在流行地区,应考虑布鲁氏菌病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/154d/9887028/540d35601f59/fmed-09-1111830-g001.jpg

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