van Crevel R, Speelman P, Gravekamp C, Terpstra W J
Department of Internal Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.
Clin Infect Dis. 1994 Jul;19(1):132-4. doi: 10.1093/clinids/19.1.132.
Between 1987 and 1991 leptospirosis in 32 Dutch travelers was diagnosed. Infections were acquired predominantly in Thailand and other Southeast Asian countries. Contact with surface waters could be confirmed in all but one case. Fever, headache, and myalgia were the most common complaints. Signs included conjunctival injection and lymphadenopathy in 11 patients each, jaundice in 8, and nuchal rigidity in 3; renal function was impaired in 8. Leptospires were isolated from the blood or urine of nine patients. Thirty-one patients developed an antibody response. Classification of strains identified a variety of serogroups. Although only 14 patients received adequate treatment, all patients recovered completely. Since the number of patients with imported leptospirosis is increasing and the signs and symptoms of the disease are not specific, leptospirosis should be included in the differential diagnosis when a traveler returns from the Tropics with fever.
1987年至1991年间，确诊了32例荷兰旅行者感染钩端螺旋体病。感染主要发生在泰国和其他东南亚国家。除1例病例外，所有病例均证实有接触地表水的情况。发热、头痛和肌痛是最常见的症状。体征包括11例患者出现结膜充血和淋巴结病，8例出现黄疸，3例出现颈部强直；8例患者肾功能受损。从9例患者的血液或尿液中分离出钩端螺旋体。31例患者出现抗体反应。菌株分类鉴定出多种血清群。尽管只有14例患者接受了充分治疗，但所有患者均完全康复。由于输入性钩端螺旋体病患者数量不断增加，且该病的症状和体征不具特异性，因此当旅行者从热带地区发热归来时，钩端螺旋体病应列入鉴别诊断范围。
