NEJM:恙虫病-案例报道

2015-12-17 chenshuo译 MedSci原创

女性,65岁,因出现持续发热3天及皮疹1天被送往医院就诊。体格检查发现,在其右腋下可见一1.5cmX1.5cm水泡破损,以及全身性的斑丘疹症状(如图A和B所示)。

女性,65岁,因出现持续发热3天及皮疹1天被送往医院就诊。


体格检查发现,在其右腋下可见一1.5cmX1.5cm水泡破损,以及全身性的斑丘疹症状(如图A和B所示)。



通过皮肤镜检查并连续4天常规摄影患处进行对比,发现皮损处已开始出现焦痂(如图C-F)。溃疡逐渐演变为黑色的痂壳,同时患处边缘有红斑环绕。

4天后,该女士身上的皮疹症状渐渐好转。

最后,在间接免疫荧光检测中,结果证实该女士患上了恙虫病(恙虫病立克次体的抗体滴度1:640)。

随后,该女士遵医嘱每日口服多西环素100mg两次,持续服用一周。2周后,该女士病情并明显好转,办理出院。

恙虫病是由恙虫病立克次体感染引起的疾病。典型的急性症状表现为发热、斑丘疹与原发病灶的演变,如本案例中所述。

此外,该病通常由恙螨进行传播,也称为恙螨,在亚洲部分地区该病最为流行。在临床上,该病所表现出的黑色焦痂是诊断的关键。

原始出处:

Chang-Seop Lee,and Jeong-Hwan Hwang, M.D.Scrub Typhus. N Engl J Med 2015; 


评论区 (4)
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  1. [GetPortalCommentsPageByObjectIdResponse(id=1997668, encodeId=5333199e66815, content=<a href='/topic/show?id=3c79528299c' target=_blank style='color:#2F92EE;'>#恙虫病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52829, encryptionId=3c79528299c, topicName=恙虫病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cd0d217, createdName=huiwelcome, createdTime=Tue Jan 19 11:25:00 CST 2016, time=2016-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=54693, encodeId=ea5c54693fe, content=好东西,值得分享,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=69b61619007, createdName=andruhn, createdTime=Fri Jan 08 19:39:00 CST 2016, time=2016-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=49702, encodeId=8d8249e0226, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Dec 27 22:30:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48298, encodeId=370c482988a, content=好文章,值得看。, beContent=null, objectType=article, channel=null, level=null, likeNumber=159, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 16:22:00 CST 2015, time=2015-12-26, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1997668, encodeId=5333199e66815, content=<a href='/topic/show?id=3c79528299c' target=_blank style='color:#2F92EE;'>#恙虫病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52829, encryptionId=3c79528299c, topicName=恙虫病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cd0d217, createdName=huiwelcome, createdTime=Tue Jan 19 11:25:00 CST 2016, time=2016-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=54693, encodeId=ea5c54693fe, content=好东西,值得分享,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=69b61619007, createdName=andruhn, createdTime=Fri Jan 08 19:39:00 CST 2016, time=2016-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=49702, encodeId=8d8249e0226, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Dec 27 22:30:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48298, encodeId=370c482988a, content=好文章,值得看。, beContent=null, objectType=article, channel=null, level=null, likeNumber=159, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 16:22:00 CST 2015, time=2015-12-26, status=1, ipAttribution=)]
    2016-01-08 andruhn

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  3. [GetPortalCommentsPageByObjectIdResponse(id=1997668, encodeId=5333199e66815, content=<a href='/topic/show?id=3c79528299c' target=_blank style='color:#2F92EE;'>#恙虫病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52829, encryptionId=3c79528299c, topicName=恙虫病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cd0d217, createdName=huiwelcome, createdTime=Tue Jan 19 11:25:00 CST 2016, time=2016-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=54693, encodeId=ea5c54693fe, content=好东西,值得分享,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=69b61619007, createdName=andruhn, createdTime=Fri Jan 08 19:39:00 CST 2016, time=2016-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=49702, encodeId=8d8249e0226, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Dec 27 22:30:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48298, encodeId=370c482988a, content=好文章,值得看。, beContent=null, objectType=article, channel=null, level=null, likeNumber=159, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 16:22:00 CST 2015, time=2015-12-26, status=1, ipAttribution=)]
    2015-12-27 忠诚向上

    值得学习

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  4. [GetPortalCommentsPageByObjectIdResponse(id=1997668, encodeId=5333199e66815, content=<a href='/topic/show?id=3c79528299c' target=_blank style='color:#2F92EE;'>#恙虫病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52829, encryptionId=3c79528299c, topicName=恙虫病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cd0d217, createdName=huiwelcome, createdTime=Tue Jan 19 11:25:00 CST 2016, time=2016-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=54693, encodeId=ea5c54693fe, content=好东西,值得分享,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=69b61619007, createdName=andruhn, createdTime=Fri Jan 08 19:39:00 CST 2016, time=2016-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=49702, encodeId=8d8249e0226, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Dec 27 22:30:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48298, encodeId=370c482988a, content=好文章,值得看。, beContent=null, objectType=article, channel=null, level=null, likeNumber=159, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 16:22:00 CST 2015, time=2015-12-26, status=1, ipAttribution=)]
    2015-12-26 hixiaoluo

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