Department of Infectious Diseases, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Am J Trop Med Hyg. 2023 Oct 9;109(6):1220-1222. doi: 10.4269/ajtmh.22-0632. Print 2023 Dec 6.
Here, we report a case of blood culture-confirmed typhoid fever, rhabdomyolysis, and multiple organ damage that arrived in our country from overseas. A 23-year-old male patient presented at our hospital with fever and muscle pain; the condition progressed rapidly. Six days after the onset of symptoms, the patient developed rhabdomyolysis and liver/kidney damage; levels of creatine kinase (CK; maximum peak: 729,869 U/L) and myoglobin (> 3,000 ng/mL) were extremely high, although the extent of renal damage was relatively mild. Blood culture showed Salmonella typhi. The patient received a combination of meropenem and levofloxacin anti-infective therapy, as well as fluid and nutritional metabolic support. He gradually recovered and was discharged after two negative blood cultures. This case highlights the fact that typhoid-induced rhabdomyolysis is a serious, life-threatening disease and that the levels of CK and myoglobin are useful indicators for evaluating typhoid-induced rhabdomyolysis. Clinicians should remain vigilant regarding travel-related illnesses associated with enteric fever.
这里，我们报告了一例血培养确诊的伤寒、横纹肌溶解症和多器官损伤的病例，该患者从海外抵达我国。一名 23 岁男性患者因发热和肌肉疼痛就诊于我院；病情迅速进展。症状出现后 6 天，患者出现横纹肌溶解症和肝/肾损伤；肌酸激酶（CK；最高峰值：729,869 U/L）和肌红蛋白（>3,000 ng/mL）水平极高，尽管肾损伤程度相对较轻。血培养显示伤寒沙门氏菌。患者接受了美罗培南和左氧氟沙星联合抗感染治疗，以及液体和营养代谢支持。两次血培养阴性后，他逐渐恢复并出院。本例强调了伤寒引起的横纹肌溶解症是一种严重的、危及生命的疾病，CK 和肌红蛋白水平是评估伤寒引起的横纹肌溶解症的有用指标。临床医生应警惕与肠热症相关的旅行相关疾病。
