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相關文獻
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題名 | Unusual Presentation of Acute Acalculous Cholecystitis in Scrub Typhus: A Case Report=以急性無結石性膽囊炎表現恙蟲病一病例報告 |
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作者 | 張源清; 林□彬; 鄭國祥; 黃富源; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 32:1 民88.01-02 |
頁次 | 頁33-36 |
分類號 | 415.26 |
關鍵詞 | 急性無結石性膽囊炎; 恙蟲病; Scrub typhus; Acute acalculous cholecystitis; Cholecystectomy; |
語文 | 英文(English) |
中文摘要 | 恙蟲病在臺灣仍是地區性傳染病,通常以急性非特異症狀表現,其中以發燒最為 常見。在此我們報告一例恙蟲病是以急性無結石性膽囊炎合併敗血症為最初表徵。病人接受 剖腹探查及膽囊切除術,術後病人臨床情況持續惡化。在血清抗體証實為恙蟲病感染後,投 與半合成四環黴素,隨即獲得改善。蒐集過去之文獻,恙蟲病雖有急性腹症之報告和病理解 剖之腹膜炎表現,但是以急性無結石性膽囊炎來表現而且為病理報告也呈現為急性無結石性 膽囊炎者,此為第一例報告。故於恙蟲病之流行區域,急性無結石性膽囊炎應將恙蟲病列入 鑒別診斷。 |
英文摘要 | Scrub typhus is an acute illness that generally presents with nonspecific symptoms and signs. We describe a case of scrub typhus that presented with acute acalculous cholecystitis and sepsis. Although the patient underwent cholecystectomy, his clinical condition did not improve. An infection of scrub typhus was suspected by positive serologic results indicating high titers of antibodies against Rickettsia tsutsugamushi. The patient recovered uneventfully after the administration of doxycycline. There have been reports of scrub typhus presenting with an acute abdomen. However, there are no reports in the literature of scrub typhus presenting with acute acalculous cholecystitis, and also presenting with acute acalculous cholecystitis in pathology. In an area where scrub typhus is endemic, this disease should be considered in the differential diagnosis of acute acalculous cholecystitis. |
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