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NEJM：慢性布鲁氏菌病案例报道

2016-06-19 MedSci MedSci原创

NEJM：慢性布鲁氏菌病-案例报道
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患者男性，86岁，居住在明尼苏达州，近日因出现发热和呼吸困难症状到急诊室就诊。  据该患者称，在20年代末的时候他曾在一个生猪屠宰场工作，而工作期间曾患过一次自限性的发热性疾病，表现为夜间盗汗和体重下降了23Kg。 体格检查未见明显异常。 腹部和骨盆部位行CT检查，结果显示脾脏局限性的钙化，大小约为4.5cmX4.2cmX2.8cm（箭头处）。 血培养结果显示布鲁氏菌感染阳性。

患者男性，86岁，居住在明尼苏达州，近日因出现发热和呼吸困难症状到急诊室就诊。

 
据该患者称，在20年代末的时候他曾在一个生猪屠宰场工作，而工作期间曾患过一次自限性的发热性疾病，表现为夜间盗汗和体重下降了23Kg。

体格检查未见明显异常。

腹部和骨盆部位行CT检查，结果显示脾脏局限性的钙化，大小约为4.5cmX4.2cmX2.8cm（箭头处）。

血培养结果显示布鲁氏菌感染阳性。

根据该患者的临床病史及实验室检查阳性结果，该患者所表现的症状与脾脏感染布鲁氏菌病一致。

最后，患者接受联合多西环素、利福平及甲氧苄啶磺胺甲药物进行治疗，在短短的10天内，患者病情明显有所好转。

对于本案例中的患者，会诊医师怀疑这次发病与以前其感染布鲁氏菌病有关。为了防止病情复发，医师对其建议终身服用多西环素以抑制病菌。  

原始出处：

Maria Costello, M.B., B.A.O., B.Ch.Mark J. Enzler, M.D. Chronic Splenic Brucellosis

N Engl J Med 2016; 374:2377June 16, 2016

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    2023-03-02 gqylhd 来自山西省

    钙化了还在发热

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2117196, encodeId=aec8211e1960b, content=钙化了还在发热, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3c31528806, createdName=gqylhd, createdTime=Thu Mar 02 11:43:43 CST 2023, time=2023-03-02, status=1, ipAttribution=山西省), GetPortalCommentsPageByObjectIdResponse(id=2029090, encodeId=53ae2029090f3, content=<a href='/topic/show?id=eb7048432c3' target=_blank style='color:#2F92EE;'>#布鲁氏菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48432, encryptionId=eb7048432c3, topicName=布鲁氏菌)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/2898B09F0DA89357D0D54A725E611AC7/100, createdBy=fdd32500040, createdName=ms7899726347904398, createdTime=Sat Jan 21 14:08:00 CST 2017, time=2017-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=161017, encodeId=3f0216101ea6, content=今天确诊了一例, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e31c1656664, createdName=永圣, createdTime=Wed Dec 07 20:12:52 CST 2016, time=2016-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=130295, encodeId=6284130295f4, content=不错哦继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Sep 18 15:32:00 CST 2016, time=2016-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97445, encodeId=ca789e44586, content=牧区常见的鲁氏菌病, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/DYAIOgq83er7gGJY7ibia1wDTTwTL7vXbqvekMBTHAsd3KZ7btXM9tnHuicI2LdxJtIiccXeDCiaTvzkwMuribZ9oHVA/0, createdBy=c7b81713099, createdName=木水晶, createdTime=Thu Aug 11 13:09:00 CST 2016, time=2016-08-11, status=1, ipAttribution=)]
    2017-01-21 ms7899726347904398

    #布鲁氏菌#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2117196, encodeId=aec8211e1960b, content=钙化了还在发热, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3c31528806, createdName=gqylhd, createdTime=Thu Mar 02 11:43:43 CST 2023, time=2023-03-02, status=1, ipAttribution=山西省), GetPortalCommentsPageByObjectIdResponse(id=2029090, encodeId=53ae2029090f3, content=<a href='/topic/show?id=eb7048432c3' target=_blank style='color:#2F92EE;'>#布鲁氏菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48432, encryptionId=eb7048432c3, topicName=布鲁氏菌)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/2898B09F0DA89357D0D54A725E611AC7/100, createdBy=fdd32500040, createdName=ms7899726347904398, createdTime=Sat Jan 21 14:08:00 CST 2017, time=2017-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=161017, encodeId=3f0216101ea6, content=今天确诊了一例, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e31c1656664, createdName=永圣, createdTime=Wed Dec 07 20:12:52 CST 2016, time=2016-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=130295, encodeId=6284130295f4, content=不错哦继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Sep 18 15:32:00 CST 2016, time=2016-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97445, encodeId=ca789e44586, content=牧区常见的鲁氏菌病, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/DYAIOgq83er7gGJY7ibia1wDTTwTL7vXbqvekMBTHAsd3KZ7btXM9tnHuicI2LdxJtIiccXeDCiaTvzkwMuribZ9oHVA/0, createdBy=c7b81713099, createdName=木水晶, createdTime=Thu Aug 11 13:09:00 CST 2016, time=2016-08-11, status=1, ipAttribution=)]
    2016-12-07 永圣

    今天确诊了一例

    0

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    2016-09-18 1e10c84am36(暂无匿称)

    不错哦继续关注

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2117196, encodeId=aec8211e1960b, content=钙化了还在发热, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3c31528806, createdName=gqylhd, createdTime=Thu Mar 02 11:43:43 CST 2023, time=2023-03-02, status=1, ipAttribution=山西省), GetPortalCommentsPageByObjectIdResponse(id=2029090, encodeId=53ae2029090f3, content=<a href='/topic/show?id=eb7048432c3' target=_blank style='color:#2F92EE;'>#布鲁氏菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48432, encryptionId=eb7048432c3, topicName=布鲁氏菌)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/2898B09F0DA89357D0D54A725E611AC7/100, createdBy=fdd32500040, createdName=ms7899726347904398, createdTime=Sat Jan 21 14:08:00 CST 2017, time=2017-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=161017, encodeId=3f0216101ea6, content=今天确诊了一例, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e31c1656664, createdName=永圣, createdTime=Wed Dec 07 20:12:52 CST 2016, time=2016-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=130295, encodeId=6284130295f4, content=不错哦继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Sep 18 15:32:00 CST 2016, time=2016-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97445, encodeId=ca789e44586, content=牧区常见的鲁氏菌病, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/DYAIOgq83er7gGJY7ibia1wDTTwTL7vXbqvekMBTHAsd3KZ7btXM9tnHuicI2LdxJtIiccXeDCiaTvzkwMuribZ9oHVA/0, createdBy=c7b81713099, createdName=木水晶, createdTime=Thu Aug 11 13:09:00 CST 2016, time=2016-08-11, status=1, ipAttribution=)]
    2016-08-11 木水晶

    牧区常见的鲁氏菌病

    0