罕见非流行地区严重钩端螺旋体病感染致感染性休克 1 例：病例报告及文献复习
A rare case of severe leptospirosis infection presenting as septic shock in a non-endemic area: a case report and literature review.
机构信息
The Second Clinical Medical College, Jinan University, Shenzhen, 518020, Guangdong, China.
Department of Infectious diseases, The Second Clinical Medical College, The First Affiliated Hospital, Shenzhen People's Hospital, Jinan University, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China.
出版信息
BMC Infect Dis. 2023 Jul 31;23(1):503. doi: 10.1186/s12879-023-08367-w.
BACKGROUND
Leptospirosis is a zoonosis caused by spirochete "genus" leptospira. The clinical presentations of leptospirosis range from an influenza-like presentation of fever and myalgia, to severe forms. Leptospirosis can potentially lead to a misdiagnosis or delay in diagnosis when clinical similarities exist.
CASE PRESENTATION
A 63-year-old man presented with fever, shock and thrombocytopenia followed by diffuse pulmonary hemorrhage. Peripheral blood Metagenomic Next-generation Sequencing (mNGS) reported Leptospira interrogans. The patient was treated with piperacillin-tazobactam (TZP) plus doxycycline and improved dramatically after 7 days.
CONCLUSION
We conclude that leptospirosis can potentially lead to a misdiagnosis or delay in diagnosis. Correctly evaluation of thrombocytopenia in acute febrile illnesses facilitates the differential diagnosis of leptospirosis. mNGS can accurately detect Leptospira DNA during the early stage of the infection.
背景
钩端螺旋体病是一种由螺旋体“属”钩端螺旋体引起的人畜共患病。钩端螺旋体病的临床表现从发热和肌痛的流感样表现到严重形式不等。当存在临床相似性时，钩端螺旋体病可能导致误诊或延迟诊断。
病例介绍
一名 63 岁男性出现发热、休克和血小板减少症，随后出现弥漫性肺出血。外周血宏基因组下一代测序 (mNGS) 报告存在问号钩端螺旋体。患者接受哌拉西林他唑巴坦（TZP）加多西环素治疗，7 天后病情明显改善。
结论
我们得出结论，钩端螺旋体病可能导致误诊或延迟诊断。正确评估急性发热性疾病中的血小板减少症有助于钩端螺旋体病的鉴别诊断。mNGS 可以在感染的早期阶段准确检测到钩端螺旋体 DNA。
Zotero 插件