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病例报告:免疫功能低下宿主复发性钩端螺旋体病。

Case Report: Relapsing Leptospirosis in an Immunocompromised Host.

机构信息

Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California.

Division of Infectious Diseases, Department of Internal Medicine, Davis School of Medicine, University of California, Sacramento, California.

出版信息

Am J Trop Med Hyg. 2023 Aug 21;109(4):730-732. doi: 10.4269/ajtmh.23-0111. Print 2023 Oct 4.

Abstract

Leptospirosis is typically a self-limited febrile illness; when it occurs, meningitis usually develops early in the course. Here, we describe a patient who had engaged in freshwater activities in Kauai that was immunocompromised due to a history of mantle cell lymphoma, autologous hematopoietic cell transplant, and hypogammaglobulinemia. He developed leptospiral meningoencephalitis 11 weeks after illness onset and persistently detectable Leptospira DNA in blood and cerebrospinal fluid along with ongoing clinical illness, despite appropriate treatment.

摘要

钩端螺旋体病通常是一种自限性发热性疾病;当它发生时,脑膜炎通常在病程早期发展。在这里,我们描述了一名患者,他因患有套细胞淋巴瘤、自体造血细胞移植和低丙种球蛋白血症而免疫功能低下,曾在考艾岛从事淡水活动。他在发病后 11 周出现钩端螺旋体脑膜脑炎,尽管进行了适当的治疗,但血液和脑脊液中仍持续存在可检测到的钩端螺旋体 DNA 以及持续存在的临床疾病。

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