一组伴有神经表现的地中海斑疹热和鼠型斑疹伤寒的病例系列。

A case series of Mediterranean spotted fever and murine typhus with neurological manifestations.

机构信息

Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia.

Laboratory of Microbiology, Habib Bourguiba University Hospital, University of Sfax, Tunisia.

出版信息

J Vector Borne Dis. 2024 Jul 1;61(3):489-494. doi: 10.4103/0972-9062.383643. Epub 2024 Sep 21.

DOI:10.4103/0972-9062.383643

PMID:39374494

Abstract

BACKGROUND OBJECTIVES

Severe cases with neurological manifestations of rickettsiosis have been reported. We aimed to identify the epidemiological, clinical and laboratory features of central nervous system rickettsial infections and to describe the treatment.

METHODS

We carried out a retrospective study that included all patients hospitalized with rickettsiosis in the infectious diseases department of Hedi Chaker University Hospital in Sfax, Tunisia between 1993 and 2018.

RESULTS

We identified 47 patients with central nervous system rickettsial infections among 440 patients with rickettsial infections (10.7%). Skin rash (31.9% vs 87.8%; p<0.001) and eschar (4.2% vs 27.7%; p<0.001) were less frequent among patients with central nervous system rickettsial infections. Complications (6.4% vs 0.5%; p=0.01) and death (4.2% vs 0.3%; p=0.03) were more frequent among patients with central nervous system rickettsial infections.

INTERPRETATION CONCLUSION

Cardinal clinical features and typical laboratory results including thrombocytopenia were less frequent, and prognosis was more severe in patients with central nervous system rickettsial infections.

摘要

背景目的

已有报道称，出现神经症状的严重立克次体病病例。我们旨在确定中枢神经系统立克次体感染的流行病学、临床和实验室特征，并描述其治疗方法。

方法

我们进行了一项回顾性研究，纳入了 1993 年至 2018 年间突尼斯斯法克斯哈迪·查克尔大学医院传染病科收治的所有立克次体病住院患者，其中 47 例患有中枢神经系统立克次体感染。

结果

在 440 例立克次体感染患者中，我们发现有 47 例（10.7%）患有中枢神经系统立克次体感染。患有中枢神经系统立克次体感染的患者皮肤疹（31.9% vs 87.8%；p<0.001）和焦痂（4.2% vs 27.7%；p<0.001）较少见。患有中枢神经系统立克次体感染的患者更常发生并发症（6.4% vs 0.5%；p=0.01）和死亡（4.2% vs 0.3%；p=0.03）。