摘要
患者,男,67岁,美籍华人,2023年8月28日晚(美国当地时间)出现发热症状,最高体温39.7℃。于8月29日在哈佛医学院麻省总院就诊,胸片提示双侧磨玻璃影,诊断为肺炎,予以阿奇霉素、苯佐那酯、阿莫西林、愈创木酚口服治疗。患者于8月31日(北京时间)到达珠海,因持续发热,于9月1日前往中山大学附属第五医院就诊。患者长期居住在美国新罕布什尔州(巴贝虫流行州),有虫子叮咬史。血常规示血红蛋白93.00 g/L↓,嗜酸粒细胞0.00×10^(9)/L↓。尿常规示尿隐血4+↑,尿蛋白2+↑。血涂片镜检可见红细胞内有田鼠巴贝虫(Babesia microti)虫体。血样荧光定量PCR扩增显示巴贝虫阳性。宏基因组二代测序检测出1 338 308条田鼠巴贝虫序列。予米诺环素(每次0.1 g,12 h 1次)+克林霉素(每次0.6 g,6 h 1次)抗感染治疗。9月11日,患者好转出院。出院前血常规示血红蛋白76.00 g/L,血小板计数208.00×10^(9)/L,谷丙转氨酶39.60 U/L,谷草转氨酶37.20 U/L。出院后2个月随访,患者恢复良好。
The patient was a 67-year-old male American Chinese. On the evening of August 28th, 2023(USlocal time), the patient developed fever symptoms, with a maximum body temperature of 39.7 ℃. On August 29th(USlocal time), he visited the Massachusetts General Hospital of Harvard Medical School. Chest X-ray showed bilateralground glass shadows, diagnosed with “pneumonia”, and was treated orally with “azithromycin, benzoate, amoxicillin,and guaiacol”. The patient arrived in Zhuhai on August 31st(Beijing time). On September 1st, he sought medical at-tention at the Fifth Affiliated Hospital of Sun Yat-sen University due to persistent fever symptoms. Admission examina-tion: hemoglobin 93.00 g/L↓, eosinophils 0.00 × 10^(9)/L↓, urinary occult blood 4 +↑, urinary protein 2 +↑. Microscopicexamination of blood smear revealed the presence of Babesia microti in red blood cells. Metagenomic next-generationsequencing(m NGS) detection of 1 338 308 sequences of Babesia microti. The patient has been residing in New Hamp-shire, USA(Babesia epidemic area) for a long time, and had a history of insect bites. The next-generation sequencingresults showed positive results for Babesia microti. The patient was treated with minocycline(0.1 g each time, once ev-ery 12 hours) + clindamycin(0.6 g each time, once every 6 hours) for anti-infection. After treatment, the condition im-proved, and the patient was discharged on September 11th. The blood count prior to discharge showed: hemoglobin76.00 g/L, platelet count 208.00 × 10^(9)/L, alanine aminotransferase 39.60 U/L, and aspartate aminotransferase 37.20 U/L.After 2 months of follow-up after discharge, the patient recovered well.
作者
赵阳阳
焦亮
ZHAO Yangyang;JIAO Liang(Zhuhai Center for Disease Control and Prevention,Zhuhai 519000,Guangdong,China)
出处
《中国寄生虫学与寄生虫病杂志》
CSCD
北大核心
2024年第3期421-423,共3页
Chinese Journal of Parasitology and Parasitic Diseases
关键词
田鼠巴贝虫
首例
输入性病例
珠海市
Babesia microti
First case
Imported cases
Zhuhai City
