病例报告:一个慢性Q热传染性内心炎的遗漏病例,证明了正在进行的诊断挑战
Victoria Grey1,2, Peter Simos3, Naomi Runnegar1,2
1Infection Management Services, Princess Alexandra Hospital, Brisbane, Australia.
Access microbiology
|December 11, 2023
概括
诊断慢性Q热可能是具有挑战性的,特别是与同时存在的条件. 这一案例突出了由Coxiella burnetii引起的假内心炎,强调了即使有负面培养或其他感染也需要考虑.
科学领域:
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 微生物学 微生物学
背景情况:
- 慢性Q热的诊断因共同病理而复杂,通常呈现为传染性内心炎或内血管感染.
- 假内心炎 (PVE) 带来了诊断挑战,特别是当由非典型生物体引起或存在多微生物感染时.
研究的目的:
- 报告一个由Streptococcus sanguinis和Coxiella burnetti引起的假感染性内心炎病例.
- 强调共感染性内心炎的诊断困难以及膜组织学的作用.
- 强调在培养负性内心炎或复发病例中考虑慢性Q热的重要性.
主要方法:
- 一个患有假内心炎的病人的病例报告.
- 对患者之前的膜组织学和流行病学风险因素的审查.
- 在膜组织上检测Coxiella burnettiDNA的聚合酶链反应 (PCR).
主要成果:
- 这位患者出现了由于Streptococcus sanguinis和Coxiella burnetti引起的假内心炎.
- 由于忽视了膜组织学,慢性Q热传染性内心炎的延迟诊断发生.
- 通过PCR在膜组织上确认了Coxiella burnettiDNA,确定了诊断.
结论:
- 慢性Q热感染性内心炎应在炎症门或带有负培养的植被的情况下被怀疑.
- 即使有替代性细菌病,也必须考虑Q热,如果患者有相关的暴露风险因素.
- 彻底的组织学审查和流行病学联系的考虑对于诊断复杂内心炎病例至关重要.
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