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临床视角下的布鲁氏菌性腹膜炎:四例综合分析

Clinical Insights into Brucella Peritonitis: A Comprehensive Analysis of Four Cases.

机构信息

Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, 510630, Guangzhou, China.

Department of Infectious Diseases, The First People's Hospital of Kashi Prefecture, 844000, Kashi, China.

出版信息

J Epidemiol Glob Health. 2024 Sep;14(3):1300-1304. doi: 10.1007/s44197-024-00287-5. Epub 2024 Aug 26.

DOI:10.1007/s44197-024-00287-5
PMID:39186210
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11442879/
Abstract

INTRODUCTION

Brucellosis, a globally distributed zoonotic disease, exhibits diverse clinical manifestations, with Brucella peritonitis being a rare but consequential complication.

METHODS

Analyzing the medical records of four patients with Brucella peritonitis admitted to the First People's Hospital of Kashi Region from January 2022 to November 2023. A retrospective approach was used to analyze the general data, epidemiological history, clinical features, laboratory tests, and efficacy. All four patients with Brucella peritonitis were farmers.

RESULTS

All of them were combined with decompensated stage of liver cirrhosis. The main manifestations were poor appetite, fatigue, bloating. Two patients were accompanied by moderate-high fever. All patients presented with mildly elevated C-reactive protein and procalcitonin < 0.25ng/ml. Brucella was cultured from blood in 2 cases, from pleural fluid in 1 case, and from ascitic fluid in another case. All patients had moderate-to-large amounts of ascites with elevated leukocytes in the ascites, predominantly mononuclear cells. Symptoms of the above patients were reduced or disappeared after effective anti-infection.

CONCLUSION

When patients with decompensated cirrhosis present with exudative ascites dominated by elevated mononuclear cells, the possibility of Brucella peritonitis should also be considered in areas where brucellosis is endemic.

摘要

简介

布鲁氏菌病是一种分布广泛的人畜共患疾病,具有多种临床表现,而布鲁氏菌性腹膜炎是一种罕见但后果严重的并发症。

方法

分析 2022 年 1 月至 2023 年 11 月期间喀什地区第一人民医院收治的 4 例布鲁氏菌性腹膜炎患者的病历。采用回顾性分析的方法对一般资料、流行病学史、临床特征、实验室检查和疗效进行分析。4 例布鲁氏菌性腹膜炎患者均为农民。

结果

均合并失代偿期肝硬化。主要表现为食欲不振、乏力、腹胀。2 例伴有中高热。所有患者均表现为 C 反应蛋白轻度升高,降钙素原<0.25ng/ml。2 例血培养布鲁氏菌阳性,1 例胸腔积液培养阳性,1 例腹水培养阳性。所有患者均有中等量至大量腹水,腹水白细胞升高,以单核细胞为主。经有效抗感染治疗后,上述患者症状减轻或消失。

结论

当失代偿期肝硬化患者出现以单核细胞升高为主的渗出性腹水时,在布鲁氏菌病流行地区也应考虑布鲁氏菌性腹膜炎的可能。

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Open Vet J. 2024 May;14(5):1081-1097. doi: 10.5455/OVJ.2024.v14.i5.1. Epub 2024 May 31.
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Brucellosis-induced peritonitis and abdominal aortitis in a non-endemic area patient on peritoneal dialysis: a case report and literature review.非流行地区腹膜透析患者布鲁氏菌病诱发的腹膜炎和腹主动脉炎:病例报告及文献综述
Front Med (Lausanne). 2024 Apr 18;11:1393548. doi: 10.3389/fmed.2024.1393548. eCollection 2024.
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Incidence and Outcomes of Brucella Endocarditis in a High-Prevalence Area: A Single-Center Study.高发地区布鲁氏菌性心内膜炎的发病率及转归:一项单中心研究。
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Risk Factors Associated with Human Brucellosis: A Systematic Review and Meta-Analysis.与人类布鲁氏菌病相关的危险因素:一项系统评价和荟萃分析
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