布鲁杆菌病泌尿生殖系统损伤及治疗研究

正布鲁杆菌病(布病)是一种人畜共患病。近年来,由于畜牧业规模不断扩大,人感染布鲁杆菌呈不断上升趋势,已成为一种常见的传染病~([1,2])。由于病程长、发病诊断复杂多变、易出现误诊而影响治疗结果,因此系统性总结布病的发病特点、临床症状、诊断及治疗结果,规范诊断和治疗标准很有必要~([3])。本研究系统性总结本院收治的160例布病患者的临床资料,分析诊断、治疗特点,旨在提高临床医师特别是普通内科医师     

布鲁杆菌OMP25蛋白前体的表达与反应原性鉴定

布鲁杆菌病(布病)是由布鲁杆菌(Brucella)引起的人兽共患病,目前在我国被称为再度肆虐的疾病。布鲁杆菌感染动物主要表现为睾丸炎、不孕不育;人类主要表现为关节痛、波浪热、肝脾肿大、多汗、神经痛等症状,给养殖业生产、人类健康和动物性食品安全带来很大威胁。做好布病的快速、准确诊断及预防显得尤为重要。目前常用血清学方法诊断布病,但存在     

胸腺肽联合氧氟沙星治疗慢性活动型布鲁氏菌病疗效分析

慢性布鲁氏菌病 (简称慢性布病 )活动型病人因病情长期反复、症状顽固 ,严重影响了患者的生存质量 ,其治疗至今在临床上仍是一个很棘手的问题。近年来我们应用高浓度胸腺肽联合氧氟沙星治疗 2 9例慢性活动型布病患者 ,收到了较好的效果 ,现报告如下。1　材料与方法1.1　病例来源　所有病例均来自我科近年来住院病人 ,共 5 9例。其诊断标准均符合国家颁布的人间布病诊断标准 [1 ]。所有病例均有不同程度的发热、关节疼痛、多汗、乏力等布病常见症状。个别病人有关节肿胀、变形或肝肿大、睾丸肿大等体征。布病血清学及布氏菌皮试均有不同程度…     

中西医结合治疗颌面部间隙感染的临床观察

颌面部间隙感染是口腔科的一种常见急性炎症性疾病,病情发展较快,如治疗不及时或治疗不当,不仅红、肿、热、痛等局部症状明显,全身反应也很严重,甚至出现败血症、脓毒血症或其他脏器的功能衰竭。2006年10月-2009年10月,我科采用中西医结合方法治疗此类疾病,效果较好。现报告如下。     

儿童Q热3例报道

Q热是一种由贝纳柯克斯体感染所致的人畜共患病,具有多种临床表现,分为急性感染和慢性感染两种类型。儿童Q热仅表现为非特异性症状或无明显症状,因此极易发生误诊、漏诊。目前实验室检查是主要的诊断标准,经宏基因组测序技术（mNGS）在Q热的早期诊断方面起着重要作用。Q热在中国并不少见,患者多来自农村或偏远地区,而基层医生对Q热认知不足,诊断技术单一,造成诊断及治疗不及时,增加了患儿罹患Q热并发症的风险。本文通过回顾性分析内蒙古自治区人民医院收治的3例Q热患儿,分析其临床资料、治疗过程,并文献复习,旨在提高基层医生对Q热的认识并进行早期诊断及早期治疗,减少相应并发症发生,同时加强基层医生对该疾病高危人群的健康宣教,并及时采取措施预防Q热的发生。     

44例布鲁菌病的临床表现和治疗研究

目的探讨布鲁菌病(布病)的临床表现、并发症、治疗及预后。方法对北京地坛医院近10年来收治的44例布病的临床资料进行回顾性分析。结果 44例布病以青壮年为主。接触传播的共24例,占总数的54.5%;发热、多汗、关节疼痛和头痛等症状为常见临床表现;肝损害21例,但程度较轻;神经系统并发症8例,多表现为脑膜炎,少数合并脑炎和脑脓肿;生殖系统并发症4例;骨关节器质性损害2例。多数患者接受多西环素联合利福平或多西环素联合链霉素治疗,部分患者接受三联治疗方案,个别患者加用复方磺胺甲噁唑,采用四联治疗方案,疗程多为6～8周。44例均好转出院,合并骨关节、神经系统并发症者预后差,可留有后遗症,病情可反复。结论布病具有高致病性,病情复杂,累及多器官,合并神经系统并发症者预后差。     

治疗慢性猪种布鲁氏菌病70例疗效观察

布鲁氏菌病（简称布病）是一种全身变态反应性疾病,以侵犯关节为主要特点。广西是猪种布病流行区,虽然从８０年代以来采取了综合性防治措施,新发病人逐年减少。但８０年代以前感染的猪种布病病人,少部分由于治疗不及时而转为慢性,至今临床症状反复发作,给病人带来极大的痛苦,而且严重影响劳动能力和身体健康。我们曾用强力霉素、利福平、穿山龙注射液、蛤蚧胶囊等中西药治疗,虽然收到明显效果,但均不能根治。近几年来,为了探索更为有效的治疗方法,我们选择症状反复发作,血清抗体滴度在１：１００以上的慢性布病病人,运用中医辨…     

115例布鲁菌病临床特点分析

目的 探索布鲁菌病(布病)患者临床特征及治疗转归情况,为临床诊治提供参考。方法 收集并分析115例成人布病患者的人口学和流行病学资料、临床表现、血液学指标及治疗与转归情况。结果 布病患者常常伴有发热、乏力、多汗、关节疼痛、肝脾肿大等临床症状,其HGB、红细胞压积(hematocrit,HCT)、嗜酸性粒细胞(eosinophil,EO)、红细胞分布宽度(red blood cell distribution width,RDW)和CRP异常率较高。而WBC、PLT、中性粒细胞计数、淋巴细胞计数、单核细胞计数、平均细胞体积、血小板分布宽度、ESR和降钙素原的异常率较低。治疗上大部分患者[53.04%(61/115)]接受利福平联合多西环素治疗,部分患者尤其是合并骨质侵犯患者常使用三联抗菌素治疗。其中47例并发骨关节痛患者,经规范足疗程治疗后皆好转或痊愈。结论 布病患者常伴有发热、乏力、多汗、关节疼痛、肝脾肿大等临床症状,其HGB、HCT、EO、RDW和CRP异常率较高,可作为布病的辅助诊断指标。布病临床表现多样,明确诊断后应尽早给予规范的抗菌治疗,抑制疾病进展,减少并发症发生。     

白城市2001～2006年布氏菌病疫情及影响因素分析

布氏菌病(以下简称布病)是由布氏菌引起的人畜共患的传染-变态反应性疾病。布病临床症状为发热、热型呈波浪型,全身及关节痛,淋巴结、肝脾与男性睾丸肿大,女性可见流产史。家畜患布病可发生流产,死胎,不孕和睾丸炎[1]。白城市是布病老疫区,2000年以来,布病疫情再度回升,部分县(     

结节性红斑的临床特点及其对结核病的诊断价值

结节性红斑(erythema nodosum,EN)是皮肤科患者一种常见体征,可见于全身多系统疾病。本综述目的旨在了解EN的临床特点及其对活动性结核病(tuberculosis,TB)的诊断价值。临床上EN主要表现为突然发作的、主要位于小腿伸侧的红色、痛性皮下软结节和斑块,与感染、药物、结节病、妊娠、炎症性肠病、口服避孕药、自身免疫性疾病、抗生素、激素反应、寄生虫感染、淋巴瘤和其他恶性肿瘤等有关,约50%病因不明,EN是由各种刺激因子引起的迟发性超敏反应。临床上非典型病例的诊断主要依赖于活检或诊断性治疗。由于EN复杂的病因,需排除皮肤结核、麻风、结节病、结节性动脉炎等全身性疾病。在TB流行区,活动性TB和结核分枝杆菌感染与EN密切相关。活动性TB并发EN、结核分枝杆菌感染并发EN患者进行抗结核治疗有助于EN症状改善、预防EN复发和控制活动性TB病情。EN与包括TB或其他全身系统疾病相关,但EN的病因有待于深入研究,EN可能是TB的早期表现,联合结核菌素皮肤试验、抗酸染色检测及影像学等技术或诊断性抗结核治疗,有助于EN并发结核分枝杆菌感染或TB的早期确诊和治愈。     

Ascites caused by brucellosis: a report of two cases

Brucellosis is a zoonosis still endemic in developing areas of the world. Focal complications of Brucellosis are well known and often troubling in the differential diagnosis. Gastrointestinal complications of Brucellosis are randomly reported, ascites being particularly rare, and usually in the context of a predisposing condition such as cirrhosis. We describe two cases of ascites attributed to Brucellosis, one in a previously healthy patient with an accompanying clinical picture of acute Brucellosis, in whom ascites reflected the response of the peritoneal mononuclear phagocytic system, and one in a HBsAg-positive, but not cirrhotic, patient, in whom Brucellosis seemed to act as a trigger effect for the development of ascites. Both cases of ascites were of an effusion type, with a predominantly lymphocytic cell count, and exhibited an excellent response to treatment with tetracycline and rifampicin.     

Food Intolerance and Gallstones: Erratum and Update of a Meta-Analysis

Brucellosis is a zoonosis still endemic in developing areas of the world. Focal complications of Brucellosis are well known and often troubling in the differential diagnosis. Gastrointestinal complications of Brucellosis are randomly reported, ascites being particularly rare, and usually in the context of a predisposing condition such as cirrhosis. We describe two cases of ascites attributed to Brucellosis, one in a previously healthy patient with an accompanying clinical picture of acute Brucellosis, in whom ascites reflected the response of the peritoneal mononuclear phagocytic system, and one in a HBsAg-positive, but not cirrhotic, patient, in whom Brucellosis seemed to act as a trigger effect for the development of ascites. Both cases of ascites were of an effusion type, with a predominantly lymphocytic cell count, and exhibited an excellent response to treatment with tetracycline and rifampicin.     

Brucellosis in a renal transplant recipient

Brucellosis is one of the most common systemic zoonotic diseases transmitted by consumption of unpasteurized dairy products or by occupational contact with infected animals. Brucellosis is rare in renal transplant recipients. Only 3 cases have been reported in the literature. We report a case of brucellosis with hematologic and hepatobiliary complications in a patient 3 years after renal transplantation. The mean time from transplantation to the diagnosis of brucellosis in these 4 reported patients was 5.1 years (range 17 months to 13 years). All patients had fever and constitutional symptoms, and all attained clinical cure after combination antibiotic therapy. Given the small number of patients, further study is needed to identify the characteristics of brucellosis in renal transplant recipients. Drug interactions and acute renal failure developed in our patient during antibiotic treatment. Therefore, we should monitor the levels of immunosuppressive agents frequently. Several studies have shown in vitro susceptibilities of Brucella melitensis to tigecycline. In our patient, fever finally subsided after tigecycline administration. The minimum inhibitory concentration of tigecycline using Etest was 0.094 μg/mL. Tigecycline may be a potential option for treatment of brucellosis in the setting of transplantation.     

Acute pericarditis after dengue fever

A 63-year-old woman was admitted for acute chest pain and asthenia worsening for one week. Clinical examination was normal. ECG revealed widespread T waves depression. Echocardiography, cardiac MR-scan, biological examinations and coronary angiogram were normal except positive dengue fever serologies. She had suffered from dengue fever recently. Clinical and ECG outcomes were good under treatment. Cardiac complications are scarce in case of dengue fever. In this case report, clinical and especially ECG presentation are typical of acute pericarditis. This pericarditis is due to dengue fever.     

布鲁菌病218例临床特征分析

目的总结布鲁菌病的流行病学特点和临床特点,为布鲁菌病防治积累临床经验。方法对经ELISA确诊并在本院住院治疗的218例布鲁菌病患者的临床资料（包括流行病学资料、临床表现及实验室检查结果等）进行回顾性分析。结果 218例布鲁菌病患者的发病时间集中在3-8月。76.1%的患者系从事养殖业的农民,以青壮年男性为主,主要经直接接触感染。发热、乏力、多汗、关节疼痛和脾大系常见临床表现,热型多不规则,关节疼痛症状多不典型。可并发骨关节损害、肝脏及心肌损害、睾丸炎、血液指标异常、心内膜炎、脑膜炎等,首诊误诊率为62.3%。结论布鲁菌病临床表现复杂多样,并发症多,易误诊,医师应加强对本病的认识以提高诊疗水平。     

新疆布鲁菌病117例临床分析

目的探讨新疆维吾尔自治区(新疆)布鲁菌病的流行情况、临床特征、实验室检查及治疗结果。方法回顾性分析我院2012年7月—2014年4月收治的117例布鲁菌病的临床特征及治疗效果。结果本地区布鲁菌病以4—9月高发,发病人群以畜牧相关人员为主。主要临床表现除发热、多汗、乏力、关节痛等一般症状外,肝脾大和淋巴结肿大也占一定比例,部分患者ALT、AST和GGT升高。治疗以多西环素联合利福平为主,好转率为97.44%。结论布鲁菌病为新疆地区发病率较高的传染病,当地有关部门应普及该病防护知识,临床医师应关注该病的临床特点及其并发症和合并症,并给予规范的抗菌治疗。     

经静脉拔除心内膜导线:目前认识和处理建议

心脏起搏器和植入型心律转复除颤器（ICD）卓越的治疗效果已为仍们所公认，随着起搏工程技术的发展，起搏治疗的适应证也不断拓宽，植入起搏器和ICD的患者越来越多，随之而来的起搏系统和ICD系统的感染，轻者植入部位皮肤局部红肿、疼痛，重者脉冲发生器囊袋积血，化脓溃破流脓，伤口经久不愈，发热，引 起菌血症或心内膜炎，拔除心内膜导和取出脉冲发生器是唯一有效的根治方法。本文对心内膜导线拔除的适应证，禁忌证，手术方法，治疗效果，并发症进行讲座，并提出建议。     

Paravertebral pyomyositis in childhood following closed injury

Pyomyositis is an acute bacterial infection that affects striated muscle and is generally accompanied by the formation of an abscess. In most cases, the microorganism involved is Staphylococcus aureus. Clinical findings are characterized by pain, swelling and muscular edema, together with variable general symptoms. Complications include arthritis, osteomyelitis and even septic shock with a mortality of 1.8%. We report the case of an 8-year-old boy who sustained a closed lumbar injury on banging his shoulder while he was playing on a trampoline and who developed paravertebral pyomyositis complicated by sepsis. S. aureus was isolated in the blood culture. The boy subsequently developed a perivertebral abscess and finally contiguous osteomyelitis in the L3 spinous process. The patient received treatment with vancomycin and metronidazole for 6 weeks followed by cloxacillin therapy for 2 weeks (a total of 8 weeks of intravenous antibiotic therapy). Physical examination 3 months after discharge revealed no abnormalities. The possibility of pyomyositis should be borne in mind, especially in children with fever, localized muscular pain and a history of accidental or sports injuries. Early diagnosis and treatment are important to reduce the risk of possibly fatal complications.