持续Q热的延迟诊断:来自中国的病例系列
Shanshan Wang1, Ke Xu1, Gang Wang2
1Department of Infectious Disease, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, 250012, China.
BMC infectious diseases
|June 17, 2024
概括
持续的Q热,由Coxiella burnetii引起,在中国经常被忽视. 超基因组测序有助于在高风险患者的诊断,即使没有典型的暴露史,使得有效的治疗.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 公共卫生 公共卫生
背景情况:
- 由Coxiella burnetii引起的Q热是一种全球普遍存在的动物传播疾病.
- 在中国,Q热的诊断不足,因为其非通报状态,导致临床挑战.
- 持续的Q热病例在常规的临床实践中经常被忽视.
研究的目的:
- 为突出中国持续性Q热的诊断挑战.
- 介绍一系列持续性Q热患者的病例.
- 强调元基因组下一代测序 (mNGS) 对于诊断Coxiella burnetii感染的实用性.
主要方法:
- 三名被诊断患有持续的Q热 (2022-2023) 的患者的回顾性病例系列.
- 收集了临床数据,病史和流行病学信息.
- 在血液或活检样本上使用元基因组下一代测序 (mNGS) 确认了诊断.
主要成果:
- 确定了三名患有持续Q热的患者 (平均年龄为63.33岁),最初的症状各异.
- 尽管在所有病例中都使用了假肢设备,但诊断延迟了 (3个月至1年).
- mNGS成功地发现了Coxiella burnetii,即使没有显著的暴露史.
结论:
- 持续的Q热在中国被低诊断,需要提高临床意识,特别是在高风险人群中.
- mNGS是识别Coxiella burnetii的宝贵工具,有助于诊断具有挑战性的Q热病例.
- 及时诊断和组合治疗 (多西环素和化) 导致成功的结果没有复发.
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