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題名 | Coinfection with Leptospirosis and Scrub Typhus--A Peport of Four Cases=鉤端螺旋體感染合併恙蟲病--四個臨床病例報告 |
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作者姓名(中文) | 何愉懷; 陳立光; 蔡佩珍; 王立信; | 書刊名 | 慈濟醫學 |
卷期 | 18:3 民95.06 |
頁次 | 頁237-240+251 |
分類號 | 415.291 |
關鍵詞 | 恙蟲病; 鉤端螺旋體; 合併感染; Leptospirosis; Scrub typhus; Coinfection; |
語文 | 英文(English) |
中文摘要 | 鉤端螺旋體感染與恙蟲病為人畜共通傳染病,鉤端螺旋體感染是經由破損的皮膚或黏膜感染,恙蟲病是經由曲受Orientia tsutsugamushi感染的恙蟲叮咬而致病。二者臨床表現類似,臨床表現不易區分。我們收集四位個案合併鉤端螺旋體及恙蟲病感染,一位病患死亡,其餘三位存活,診斷方法包括血清抗體IgG四倍上升或多聚合酵素鏈鎖反應(PCR)陽性。鉤端螺旋體合併恙屬病感染臨床表現不易區分,早期二者均可造成發燒、頭痛、夜疹、肌肉酸痛、結膜充血。兩者對於嚴重病患圾可造成多重器官衰竭包括肺炎、腦炎、心肌炎、急性腎臟衰竭、肝炎及泛發性血管內血液凝固症。醫師對於發燒病患如有野外或動物接災病史等提高警覺是否有合併感染之可能,早期用藥可提高病患存活率,aqueous penicilli合併新一代的fluoroquinolone為本院目前針對斿似非典型感染之病患的處理原則。 |
英文摘要 | Leptospirosis and scrub typhus are zoonoses with worldwide distribution. The spectra of clinical severity are wide for both disease, ranging from mild to fatal. A dignosis of coinfection with leptospirosis and scrub typhus can be difficult to make if the exposure history is overlooked but patients can die if not treated early. Herein we present four such cases, on patient died due to delayed diagnosis, while the other three survived without sequelae. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。