PDF(Pubmed)
Abstract：
BACKGROUND: Tsutsugamushi, also known as bush typhus, is a naturally occurring disease caused by Orientia tsutsugamushi. We reported a case of vertical mother-to-newborn transmission of Orientia tsutsugamushi infection in a newborn from Yunnan (China).
METHODS: Decreased fetal movements were observed at 39 weeks of gestation. After birth, the newborn (female) had recurrent fever, shortness of breath, and bruising around the mouth and extremities. At 5 h 58 min of age, the newborn was admitted for fever, shortness of breath and generalized rash. The liver was palpable 3 cm below the costal margin, and the limbs showed pitting edema. There was subcutaneous bleeding. Investigations suggested heavy infection, myocardial damage, decreased platelets. Treatment with cefotaxime and ampicillin failed. The mother was hospitalized at 29 weeks of gestation with a fever for 4 consecutive days, and an ulcerated crust was found in the popliteal fossa. Due to this pregnancy history, A diagnosis of Orientia tsutsugamushi infection was suspected in our index case and confirmed by macrogenomic testing and she was treated with vancomycin and meropenem, and later azithromycin for 1 week. The newborn was discharged in good general condition, gradually normalizing body temperature, and decreasing rash and jaundice. There were no abnormalities on subsequent blood macrogenomic tests for the baby. And one month later she showed good mental health, sleep, and food intake and no fever, rash, or jaundice.
CONCLUSIONS: Determining the cause of symptoms is the key to treating diseases, especially the rare diseases that can be misdiagnosed.
UNASSIGNED: Infectious Diseases; Neonatology; Obstetrics.
METHODS: Decreased fetal movements were observed at 39 weeks of gestation. After birth, the newborn (female) had recurrent fever, shortness of breath, and bruising around the mouth and extremities. At 5 h 58 min of age, the newborn was admitted for fever, shortness of breath and generalized rash. The liver was palpable 3 cm below the costal margin, and the limbs showed pitting edema. There was subcutaneous bleeding. Investigations suggested heavy infection, myocardial damage, decreased platelets. Treatment with cefotaxime and ampicillin failed. The mother was hospitalized at 29 weeks of gestation with a fever for 4 consecutive days, and an ulcerated crust was found in the popliteal fossa. Due to this pregnancy history, A diagnosis of Orientia tsutsugamushi infection was suspected in our index case and confirmed by macrogenomic testing and she was treated with vancomycin and meropenem, and later azithromycin for 1 week. The newborn was discharged in good general condition, gradually normalizing body temperature, and decreasing rash and jaundice. There were no abnormalities on subsequent blood macrogenomic tests for the baby. And one month later she showed good mental health, sleep, and food intake and no fever, rash, or jaundice.
CONCLUSIONS: Determining the cause of symptoms is the key to treating diseases, especially the rare diseases that can be misdiagnosed.
UNASSIGNED: Infectious Diseases; Neonatology; Obstetrics.
摘要：
背景：Tsu虫，也被称为灌木斑疹伤寒，是一种自然发生的疾病，由Orientia虫引起。我们报告了一例来自云南（中国）的新生儿中的T6虫感染的垂直母婴传播。
方法：在妊娠39周时观察到胎动减少。出生后,新生儿(女性)反复发烧，呼吸急促,嘴巴和四肢周围有瘀伤.在5小时58分钟的年龄，新生儿因发烧入院，呼吸急促和全身皮疹。肝脏可触及肋缘以下3厘米，四肢出现凹陷性水肿。皮下出血.调查显示严重感染，心肌损伤,血小板减少。头孢噻肟和氨苄西林治疗失败。母亲在妊娠29周时因连续4天发烧住院,在the窝发现了一个溃疡皮。由于这个怀孕史，在我们的索引病例中，怀疑诊断为Tu虫感染，并通过大基因组测试证实，并接受了万古霉素和美罗培南治疗。然后阿奇霉素1周。新生儿已出院,一般情况良好,逐渐使体温正常化，减少皮疹和黄疸。婴儿随后的血液宏观基因组测试没有异常。一个月后，她表现出良好的心理健康，睡眠,食物摄入和没有发烧，皮疹,或者黄疸.
结论：确定症状的病因是治疗疾病的关键，尤其是可以误诊的罕见疾病。
■传染病；新生儿科；产科。
方法：在妊娠39周时观察到胎动减少。出生后,新生儿(女性)反复发烧，呼吸急促,嘴巴和四肢周围有瘀伤.在5小时58分钟的年龄，新生儿因发烧入院，呼吸急促和全身皮疹。肝脏可触及肋缘以下3厘米，四肢出现凹陷性水肿。皮下出血.调查显示严重感染，心肌损伤,血小板减少。头孢噻肟和氨苄西林治疗失败。母亲在妊娠29周时因连续4天发烧住院,在the窝发现了一个溃疡皮。由于这个怀孕史，在我们的索引病例中，怀疑诊断为Tu虫感染，并通过大基因组测试证实，并接受了万古霉素和美罗培南治疗。然后阿奇霉素1周。新生儿已出院,一般情况良好,逐渐使体温正常化，减少皮疹和黄疸。婴儿随后的血液宏观基因组测试没有异常。一个月后，她表现出良好的心理健康，睡眠,食物摄入和没有发烧，皮疹,或者黄疸.
结论：确定症状的病因是治疗疾病的关键，尤其是可以误诊的罕见疾病。
■传染病；新生儿科；产科。
