Devereaux C E
Department of Internal Medicine (Gastroenterology Division), Naval Medical Center, San Diego, California 92134-5000, USA.
J Clin Gastroenterol. 1997 Oct;25(3):544-5. doi: 10.1097/00004836-199710000-00014.
I report a case of tick-borne ehrlichiosis in which the primary presentation suggested an infectious diarrhea, with impressive leukopenia and thrombocytopenia. Ehrlichiosis must be included in the differential diagnosis of febrile diarrhea in endemic areas because delay in therapy allows complications and sometimes death. In patients with apparent febrile diarrhea, the presence of leukopenia and thrombocytopenia or elevated aminotransferase values should alert the physician to look for a history of tick bites and consider treatment with doxycycline or tetracycline.
我报告一例蜱传埃立克体病，其最初表现提示为感染性腹泻，并伴有显著的白细胞减少和血小板减少。在流行地区，发热性腹泻的鉴别诊断必须包括埃立克体病，因为治疗延迟会导致并发症，有时甚至会死亡。对于明显发热性腹泻的患者，白细胞减少、血小板减少或转氨酶值升高应提醒医生询问蜱叮咬史，并考虑用多西环素或四环素进行治疗。
