PDF(Pubmed)
Abstract：
UNASSIGNED: Rickettsioses are infectious diseases which are caused by intracellular bacteria which belong to the family Rickettsiaceae. This zoonosis endemically prefers tropical and subtropical regions of which the Mediterranean is included. Murine typhus is a type of rickettsial disease that commonly presents with undulating fever, headache rash, chills, malaise, and myalgias. It can lead to complications such as multi-organ failure and has a lethality rate of <5% in such cases.
UNASSIGNED: A 70-year-old male was hospitalized at the Unit of Infectious Diseases, Mother Teresa Hospital, Tirana, Albania in a comatose condition. He had a seven-day history of fever up to 39-40°C, headache, fatigue, anorexia, vomiting, cough, and myalgia. He was a farmer and had contact with animals. Upon admission, he had scleral hemorrhages, hepatosplenomegaly, jaundice, maculopapular rash over the trunk, abdomen, and palms of his hands as well as severe acidosis, depressed bicarbonate levels, alteration in liver, kidney, and pancreas function tests. He was urgently transferred to the Intensive care unit of the Infectious Diseases Department. He was hemodynamically unstable and was put immediately on vasoactive agents and mechanical ventilation. ELISA Rickettsia typhi IgM resulted positive. Supportive treatment along with antibiotics Levofloxacin and Ceftriaxone was initiated. However, the patient died on the 4th day of hospitalization and the 11th of the disease onset.
UNASSIGNED: Murine typhus should be included in the investigation of possible causes when dealing with patients presenting with fever and maculopapular rash complicated by multi-organ failure and coming from a typhus-endemic area, especially in the summer season.
UNASSIGNED: A 70-year-old male was hospitalized at the Unit of Infectious Diseases, Mother Teresa Hospital, Tirana, Albania in a comatose condition. He had a seven-day history of fever up to 39-40°C, headache, fatigue, anorexia, vomiting, cough, and myalgia. He was a farmer and had contact with animals. Upon admission, he had scleral hemorrhages, hepatosplenomegaly, jaundice, maculopapular rash over the trunk, abdomen, and palms of his hands as well as severe acidosis, depressed bicarbonate levels, alteration in liver, kidney, and pancreas function tests. He was urgently transferred to the Intensive care unit of the Infectious Diseases Department. He was hemodynamically unstable and was put immediately on vasoactive agents and mechanical ventilation. ELISA Rickettsia typhi IgM resulted positive. Supportive treatment along with antibiotics Levofloxacin and Ceftriaxone was initiated. However, the patient died on the 4th day of hospitalization and the 11th of the disease onset.
UNASSIGNED: Murine typhus should be included in the investigation of possible causes when dealing with patients presenting with fever and maculopapular rash complicated by multi-organ failure and coming from a typhus-endemic area, especially in the summer season.
摘要：
■立克次体病是由属于立克次体科的胞内细菌引起的传染病。这种人畜共患病流行于包括地中海在内的热带和亚热带地区。鼠斑疹伤寒是一种立克次体疾病，通常表现为起伏的发烧，头痛皮疹,发冷,萎靡不振,和肌痛。它可以导致并发症，如多器官功能衰竭，在这种情况下，致死率<5％。
一名70岁的男性在传染病科住院，特蕾莎修女医院,地拉那,处于昏迷状态的阿尔巴尼亚。他有7天的发烧史，最高可达39-40°C，头痛,疲劳,厌食症,呕吐,咳嗽,和肌痛。他是个农夫，跟动物有过接触。一被录取,他有巩膜出血,肝脾肿大,黄疸,躯干上的斑丘疹,腹部，他的手掌以及严重的酸中毒，碳酸氢盐水平下降，肝脏的改变，肾,和胰腺功能测试.他被紧急转移到传染病科的重症监护室。他血流动力学不稳定，立即接受血管活性剂和机械通气。ELISA伤寒立克次体IgM结果为阳性。开始与抗生素左氧氟沙星和头孢曲松一起进行支持性治疗。然而,患者在住院第4天和疾病发作第11天死亡。
当处理出现发热和斑丘疹并发多器官功能衰竭并来自斑疹伤寒流行区的患者时，应将鼠斑疹伤寒纳入可能原因的调查中。尤其是在夏季。
一名70岁的男性在传染病科住院，特蕾莎修女医院,地拉那,处于昏迷状态的阿尔巴尼亚。他有7天的发烧史，最高可达39-40°C，头痛,疲劳,厌食症,呕吐,咳嗽,和肌痛。他是个农夫，跟动物有过接触。一被录取,他有巩膜出血,肝脾肿大,黄疸,躯干上的斑丘疹,腹部，他的手掌以及严重的酸中毒，碳酸氢盐水平下降，肝脏的改变，肾,和胰腺功能测试.他被紧急转移到传染病科的重症监护室。他血流动力学不稳定，立即接受血管活性剂和机械通气。ELISA伤寒立克次体IgM结果为阳性。开始与抗生素左氧氟沙星和头孢曲松一起进行支持性治疗。然而,患者在住院第4天和疾病发作第11天死亡。
当处理出现发热和斑丘疹并发多器官功能衰竭并来自斑疹伤寒流行区的患者时，应将鼠斑疹伤寒纳入可能原因的调查中。尤其是在夏季。
