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捷尔诺波尔州的一例钩端螺旋体病合并雅-赫反应。

A case of leptospirosis in transcarpathia complicated with Jarisch-Herxheimer reaction.

机构信息

UZHHOROD NATIONAL UNIVERSITY, UZHHOROD, UKRAINE; REGIONAL CLINICAL INFECTIOUS DISEASES HOSPITAL, UZHHOROD, UKRAINE.

REGIONAL CLINICAL INFECTIOUS DISEASES HOSPITAL, UZHHOROD, UKRAINE.

出版信息

Wiad Lek. 2024;77(3):608-612. doi: 10.36740/WLek202403134.

Abstract

A case report of Jarisch-Herxheimer (JHR) reaction on a 10th day of Leptospirosis caused by Leptospira Pomona. JHR occurs as a complication of an antibiotic treatment of various spirochetes and may lead to respiratory distress syndrome, renal failure, hepatic insufficiency, and multiple organ failure. This case represents a skin and cardio-vascular form of JHR with no lung involvement. The patient was treated with benzylpenicillin and low dexamethasone doses for 5th day of the disease with a shift to ceftriaxone and high doses of methylprednisolone. The fastest diagnosis of a sporadic zoonotic disease, early start of antibiotic therapy, and adequate doses of corticosteroids are key to the successful treatment of leptospirosis.

摘要

波蒙那无形体莱姆病的第十天出现雅里施-赫克斯海默(JHR)反应 1 例报告。JHR 是各种螺旋体抗生素治疗的并发症,可能导致呼吸窘迫综合征、肾衰竭、肝功能不全和多器官衰竭。本病例代表 JHR 的皮肤和心血管形式,无肺部受累。患者在疾病的第 5 天接受苯唑西林和低剂量地塞米松治疗,然后转为头孢曲松和大剂量甲基强的松龙治疗。对散发性人畜共患疾病的最快诊断、早期开始抗生素治疗和足够剂量的皮质类固醇是成功治疗莱姆病的关键。

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