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神经型钩端螺旋体病——一个棘手的诊断难题。

Neuro-leptospirosis - A batty diagnostic enigma.

作者信息

Nguyen Lauren, Chimunda Timothy

机构信息

Mackay Base Hospital, Queensland Health, Queensland, Australia.

University of Melbourne, School of Medicine, Victoria, Australia.

出版信息

IDCases. 2023 Mar 5;32:e01731. doi: 10.1016/j.idcr.2023.e01731. eCollection 2023.

Abstract

Leptospirosis is an important, worldwide zoonotic, with a high incidence in warm-climate and tropical countries. Leptospirosis has a broad spectrum of manifestations, from a non-specific febrile illness to severe disease with multi-organ involvement. Transmission typically occurs following exposure to urine from infected animals, in particular domesticated animals such as rodents and cattle. Leptospira species have been identified in bats, however bat-human transmission is uncertain, and bat-associated leptospirosis in humans is seldom reported. We report a unique case of severe neuro-leptospirosis resulting from bat exposure with an unusual manifestation of a non-traumatic subarachnoid haemorrhage, and the diagnostic challenges it presented.

摘要

钩端螺旋体病是一种重要的全球性人畜共患病,在气候温暖的国家和热带国家发病率较高。钩端螺旋体病有广泛的临床表现,从非特异性发热性疾病到累及多个器官的严重疾病。传播通常发生在接触受感染动物的尿液之后,特别是啮齿动物和牛等家畜。已在蝙蝠体内发现钩端螺旋体属,但蝙蝠与人之间的传播尚不确定,人类中与蝙蝠相关的钩端螺旋体病鲜有报道。我们报告了一例因接触蝙蝠导致的严重神经型钩端螺旋体病的独特病例,该病例有非创伤性蛛网膜下腔出血这一不寻常表现,以及其所带来的诊断挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a270/10018540/775069627680/gr1.jpg

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