摘要
目的了解以不明原因发热（FUO）就诊而最终诊断为布鲁菌病的患者的临床特征，提高非疫区医师对该疾病的重视。方法收集2005年6月至2016年7月复旦大学附属华山医院及静安分院感染科以FUO就诊最终确诊为布鲁菌病的19例患者的临床资料，回顾性总结其流行病学特征、临床表现、辅助检查、诊治过程及预后情况。结果19例患者平均年龄48岁；女3例，男16例；17例有疫畜接触史或疫区生活史。其中14例伴肝、脾或淋巴结肿大，9例骨关节受累且均累及脊柱，3例合并睾丸炎，1例布鲁菌脑病伴周围神经病变，1例脑脊膜炎，1例感染性横贯性脊髓炎后遗症。7例血培养布鲁杆菌阳性，所有患者试管凝集试验示血清抗体均阳性。采用以多西环素联合其他抗菌药物的两联或三联强化抗菌治疗，19例患者症状均得到了改善，其中4例随访脑脊液和脊柱MRI有所好转。结论对非疫区FUO者根据其临床表现结合其流行病学特点需考虑布鲁菌病可能。
Objective To analyze the clinical characteristics of brucellosis cases with fever of unknown origin （FUO） as initial manifestation, and to further raise awareness of doctors in non-epidemic areas. Methods Clinical data of 19 brucellosis cases with FUO as initial manifestation in Huashan Hospital, Fudan University and Jingr an braneh from June 2005 to July 2016 were collected. The epidemiological, clinical, assistant examination, imaging, treatment and prognosis data of these patients were retrospectively analyzed. Results The average age of the 19 cases was 48 years old, of whom 3 were female and 16 were male. Seventeen cases had the history of contact with sick livestock or epidemic areas. The main clinical manifestations were hepatomegaly or splenornegaly or lymphadenectasis （14 cases）, bone, joint and spine involvement （9 cases）, orehitis （3 cases）, encephalopathy and peripheral neuropathy （1 case）, infectious myelitis （1 case） and sequelae of infectious transverse myelitis （1 case）. Brucella was detected in 7 patients by blood culture. The agglutination test of serum antibody were 100% positive. All patients got improvement after ant-Brucella therapeutic regimen based on doxycycline. Conclusion Brucellosis should be considered for patients with FUO from non epidemic areas according to clinical and epidemic features.
出处
《中华传染病杂志》
CSCD
北大核心
2017年第8期477-480,共4页
Chinese Journal of Infectious Diseases
关键词
布鲁菌病
不明原因发热
非疫区
临床特征
Brucellosis
Fever of unknown origin
Non-epidemicareas
Clinical features
