摘要
目的报告江门市1例成人布鲁菌病(简称布病)病例的诊疗及病因调查等情况,为江门市布病防控提供依据。方法收集患者诊治全过程的门诊和住院病历资料,对其基本情况、发病及诊疗过程、密切接触人员、生活习惯和环境、预后转归等情况进行调查综合分析,明确诊断及病因,并采取针对性的处置措施。结果患者为家庭主妇,无其他布病患者接触史,于2021年2月2日自行购买、处理生羊胎盘;2021年5月15日开始出现左下肢疼痛等症状,先后在江门市五邑中医院门诊及住院、私人中医诊所诊治,皆以其他疾病诊断治疗;7月25日再次因腰痛伴左下肢放射性疼痛入住江门市五邑中医院,患者血需氧菌培养布鲁菌阳性(+),结合患者关节痛、发热、大汗等临床表现,诊断为布病;于8月6日转江门市人民医院继续治疗,经利福平、阿米卡星、多西环素联合治疗后症状得以缓解。该病例确诊为因接触、处理羊胎盘引起的布鲁菌病,依据《布鲁氏菌病诊疗指南》开展针对性的处置工作。结论综合临床诊疗情况及部分流行病学调查结果,本文病例确定为布鲁菌感染患者,考虑因暴露于携带该菌的生羊胎盘引起。江门市作为布病控制区,应加强对布病防治知识的宣传教育和培训,加强对引进牲畜的检疫和职业重点人群监测。
Objective To report the diagnosis,treatment and etiological investigation of a case of adult brucellosis in Jiangmen city,and provide basis for prevention and control of brucellosis in Jiangmen city.Methods The outpatient and inpatient medical records of the patient during the whole process of diagnosis and treatment were collected,investigated and comprehensively analyzed for the process of pathogenesis,diagnosis,treatment,close contacts,living habits and environment,prognosis.Results The patient was a housewife and had no contact history with other brucellosis patients.On February 2,2021,she purchased and processed a raw sheep placenta by herself.On May 15,2021,she began to have left lower limb pain and other symptoms,and she was diagnosed and treated in the outpatient,inpatient of Wuyi Traditional Chinese Medicine Hospital of Jiangmen and private traditional Chinese medicine clinic;all of which,were diagnosed and treated with other diseases.On July 25,she was admitted to Wuyi Traditional Chinese Medicine Hospital of Jiangmen again because of low back pain and radiation pain of the left lower limb,and her blood aerobic bacteria culture was brucella positive(+);of which,combined with the clinical manifestations such as joint pain,fever and sweating,she was diagnosed as brucellosis.On August 6,she was transferred to the People’s Hospital of Jiangmen for further treatment and the symptoms were relieved after the combined treatment with rifampicin,amikacin and doxycycline.The case was diagnosed as brucellosis caused by contacting and processing the sheep placenta,and the targeted treatment was carried out according to“Guidelines for the Diagnosis and Treatment of Brucellosis”.Conclusions Based on the clinical diagnosis and treatment and some epidemiological investigation results,this case was determined as a patient with Brucella infection,which was caused by exposure to the placenta of raw sheep carrying the bacterium.As a brucellosis control area for Jiangmen city,we should strengthen the publicity,education and training of the prevention and control knowledge of brucellosis,and strengthen the quarantine of imported livestock and the monitoring of key occupational groups.
作者
区子昌
李东
阮炳威
曾广忠
OU Zi⁃chang;LI Dong;RUAN Bing⁃wei;ZENG Guang⁃zhong(Department of Infectious Disease,the People's Hospital of Jiangmen,Jiangmen,Guangdong 529000,China)
出处
《热带医学杂志》
CAS
2021年第12期1626-1629,共4页
Journal of Tropical Medicine
关键词
布鲁菌病
羊胎盘
成人
Brucellosis
Sheep placenta
Adult
作者简介
区子昌(1975-),男,本科,副主任医师,从事感染科工作,E⁃mail:492922466@qq.com
