背景:鼠疫是由鼠疫耶尔森氏菌引起的急性传染病。历史上,这是一个死亡率很高的大流行病,在14世纪被称为“黑死病”,导致欧洲数百万人死亡。随着经济的日益繁荣,越来越多的人去西藏旅行。然而,这种趋势也隐藏了重大的安全隐患。目前,最近关于鼠疫的报道很少,尤其是那些有影像学表现的人。在这项研究中,我们报告了西藏肺鼠疫患者的详细临床和放射学数据,中国,2023年。
方法:我们报告了西藏一例肺鼠疫,发生在一个住在发现死亡土拨鼠的地区的牧民中。病人出现发烧等症状,咯血,呼吸困难和昏迷。胸部计算机断层扫描(CT)扫描显示多个结节分布在肺叶的中央区域,巩固分布在继发性肺小叶中,并且具有重力依赖的分布模式。这些影像学表现与肺出血和弥漫性肺泡损伤一致。尽管有紧急治疗,患者在入院48小时内死亡。通过回顾性病史调查,实验室检查和尸检,最终诊断为肺鼠疫。
结论:肺鼠疫是最致命的传染病,其病理特征主要包括肺泡损伤,肺出血,和肺水肿。对应于CT,它表现为急性和快速进展的肺炎,肺泡损伤,和肺出血。本文的价值在于影像资料的完整性和典型性,生动的手绘插图的传输途径,和全面的文献综述,所有这些都有助于提高公众对鼠疫的认识,并发挥重要的警告作用。
BACKGROUND: Plague is an acute infectious disease caused by the Yersinia pestis. Historically, it has been a major pandemic with high mortality rates, known as the \"Black Death\" in the 14th century, which resulted in millions of deaths in Europe. With increasing economic prosperity, more and more people are traveling to Xizang. However, this trend also hides significant safety hazards. Currently, there are few recent reports on plague, especially those with imaging manifestations available. In this study, we report the detailed clinical and radiological data of the patient with pneumonic plague in Xizang, China, in 2023.
METHODS: We report a case of pneumonic plague in Xizang, which occurred in a herdsman living in an area where dead marmots were found. The patient presented with symptoms such as fever, hemoptysis, dyspnea and coma. Chest computed tomography (CT) scans showed multiple nodules distributed in the central regions of lung lobes, consolidation distributed in secondary pulmonary lobules, and had a gravity-dependent distribution pattern. These imaging findings were consistent with pulmonary hemorrhage and diffuse alveolar damage. Despite emergency treatment, the patient died within 48 h of admission. Through retrospective medical history investigation, laboratory examination and autopsy, the final diagnosis was confirmed as pneumonic plague.
CONCLUSIONS: Pneumonic plague is the most deadly infectious disease, and its pathological features mainly include damage to the alveoli, pulmonary hemorrhage, and pulmonary edema. Corresponding to CT, it manifests as acute and rapidly progressing pneumonia, alveolar damage, and pulmonary hemorrhage. The value of this article lies in the completeness and typicality of the imaging data, vivid hand-drawn illustrations of transmission pathways, and comprehensive literature
review, all of which serve to enhance public understanding of plague and play an important warning role.