布鲁杆菌病误诊并引发实验室人员感染原因分析

目的探讨不典型布鲁杆菌病的临床特点及实验室人员感染该病的原因。方法对我院收治的布鲁杆菌病2例的临床资料进行回顾性分析。结果例1因发热11 d入院,先后误诊为上呼吸道病毒感染、病毒性睾丸炎、风湿免疫疾病,后行多次骨髓培养及血培养诊断为人葡萄球菌性脓毒症,予敏感抗生素治疗后体温恢复正常出院。2个月后再次出现发热及左踝关节肿痛入院,此时接触该患者血培养标本的实验室人员也出现发热,2例查布鲁杆菌血清凝集试验均阳性,血培养均有马耳他布鲁杆菌生长,确诊为布鲁杆菌病。予利福平联合多西环素治疗痊愈。结论非疫区布鲁杆菌病患者多无明确的患畜或其污染物接触史,且临床表现复杂多样,易误诊。实验室人员应提高对布鲁杆菌的鉴定水平且注意自身防护。

Misdiagnosis Analysis of Laboratory Personnels Infection Induced by Brucellosis

Objective To explore clinical characteristics of atypical brucellosis and the reasons of Laboratory infec- tion. Methods Clinical data of 2 patients with brucellosis in our hospital was retrospectively analyzed. Results One patient was admitted for 11 days of fever, and was successively misdiagnosed as having upper respiratory tract infection, viral orehitis, rheumatism and immune diseases. After bone marrow and blood cultures for many times, the patient was diagnosed as having staphylococcus hominis sepsis, and was discharged from hospital with normal body temperature after sensitive antibiotics treat- ment. The patient was admitted for fever and swell in the left ankle joint again two months later, meanwhile, a laboratory per- sonnel, who contacted the specimen of the patientg blood culture, also had fever. Results of serum agglutination test of the two patients were positive, and Malta brucella was found in blood culture of the 2 patients, and then brucellosis was finally con- firmed. The two patients recovered after Rifampin complicated with Doxycycline treatment. Conclusion Brucellosis patients are easily misdiagnosed because of unclear contacting history with sick animals or its pollutants in non-affected areas and multi- farious clinical manifestations. So laboratory personnels should enhance identification awareness, and pay more attention to protect themselves.