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钩端螺旋体病的有效管理:多西环素与头孢曲松联合治疗的病例报告

Effective Management of Leptospirosis: A Case Report of Combined Doxycycline and Ceftriaxone Therapy.

作者信息

Timande Chetan A, Kanyal Deepika R, Bhargava Aditya K, Sabale Shantanu R, Mahajan Sanket, Dakre Sudhanshu M

机构信息

Hospital Administration, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Aug 27;16(8):e67909. doi: 10.7759/cureus.67909. eCollection 2024 Aug.

Abstract

Leptospirosis is a bacterial infection caused by the pathogen Leptospira. The disease is primarily transmitted through contact with animals (mainly rats) or through exposure to contaminated water or soil. Underdeveloped countries and places with poor housing and sanitation are at higher risk. Leptospirosis often presents with nonspecific symptoms, making it difficult to diagnose. This can delay the initiation of appropriate treatment. In the case presented, the patient had a history of cough, high fever, and a rash over various parts of the body. This combination of respiratory symptoms, systemic fever, and dermatological manifestations led to the suspicion of an infection. Initial blood examinations revealed a significantly increased white blood cell (WBC) count, indicating an infection. Further enzyme-linked immunosorbent assay (ELISA) testing was confirmed by active immunoglobulin M (IgM) antibodies specific to leptospira species, followed by a chest X-ray scan. The antibiotics doxycycline (for seven days) and ceftriaxone (two weeks) were used to treat the leptospirosis. The patient was also given antipyretics to bring down fever and antitussive agents to suppress the cough. Hydration and breathing exercises were also given high priority in healing from this illness. After treatment, the patient did very well, he sweated less before dawn, the rash started to go away, and finally, even coughing was controlled. Further blood tests have shown that now the WBC is in the normal range and the IgM antibody level has dropped. In other words, the infection has been eradicated. For detailed information, refer to the case study "A Moral Call," which argues that early treatment and intervention are critical in managing leptospirosis. Getting this severe infection with early antibiotic therapy and nursing care gives people a chance for complete recovery from their illness. There must be more studies into this disease's long-term effects and how to prevent it when the risk group is more significant.

摘要

钩端螺旋体病是由病原体钩端螺旋体引起的细菌感染。该疾病主要通过与动物(主要是老鼠)接触或接触受污染的水或土壤传播。欠发达国家以及住房和卫生条件差的地区风险更高。钩端螺旋体病常表现为非特异性症状,难以诊断。这可能会延迟适当治疗的开始。在该病例中,患者有咳嗽、高热和全身皮疹病史。这种呼吸道症状、全身性发热和皮肤表现的组合引发了感染的怀疑。初步血液检查显示白细胞(WBC)计数显著增加,表明存在感染。进一步的酶联免疫吸附测定(ELISA)检测通过针对钩端螺旋体属的活性免疫球蛋白M(IgM)抗体得到证实,随后进行了胸部X光扫描。使用强力霉素(七天)和头孢曲松(两周)抗生素治疗钩端螺旋体病。还给予患者退烧药以降低体温和止咳药以抑制咳嗽。补液和呼吸练习在该疾病的康复中也被高度重视。治疗后,患者恢复良好,黎明前出汗减少,皮疹开始消退,最后咳嗽也得到了控制。进一步的血液检查表明,现在白细胞处于正常范围,IgM抗体水平下降。换句话说,感染已被根除。有关详细信息,请参考病例研究《道德呼吁》,该研究认为早期治疗和干预对管理钩端螺旋体病至关重要。通过早期抗生素治疗和护理来控制这种严重感染,能让人们有机会从疾病中完全康复。对于该疾病的长期影响以及当风险群体更显著时如何预防,必须进行更多研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eff4/11436254/c4f6cdeca77b/cureus-0016-00000067909-i01.jpg

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