不明原因发热病人钩端螺旋体和巴尔通体感染调查  

Investigation of leptospirosis and bartonella infection in patients with fever of unknown origin

作　　者：王跃兵[1] 杨向东[1] 杨发莲[1] 彭海燕[1] 于彬彬[1] 杨慧[1] 

机构地区：[1]云南省地方病防治所,云南大理671000

出　　处：《实用预防医学》2015年第4期430-432,共3页Practical Preventive Medicine

基　　金：云南省科技厅应用基础研究计划面上项目(No.2011FB135)

摘　　要：目的了解不明原因发热病人钩端螺旋体和巴尔通体的感染状况。方法用显微镜凝集实验方法检测不明原因发热病人血清的钩端螺旋体抗体,用间接免疫荧光法检测血清的汉塞巴尔通体和五日热巴尔通体IgG抗体水平。结果共检测232份不明原因发热病人血清。感染率:汉塞巴尔通体(30.17%)>五日热巴尔通体(18.10%)>钩端螺旋体(4.74%),混合感染率:汉塞巴尔通体和五日热巴尔通体(14.22%)>钩端螺旋体和汉塞巴尔通体(2.16%)>钩端螺旋体和五日热巴尔通体(0.86%),1例病例三项抗体阳性。结论不明原因发热病人中有一定比率的病例是因为感染钩端螺旋体,和/或汉塞巴尔通体、五日热巴尔通体而引起的发热,感染率各不相同,混合感染较为普遍。在不明原因发热的诊断中,有必要进行钩端螺旋体病和巴尔通体病的诊断筛查。Objective To investigate the leptospirosis and bartonella infection among patients with fever of unknown origin （FUO） in Yunnan Province. Methods For the patients with FUO, serum leptospirosis antibody was tested by microscope agglutination test （MAT）, and serum Bartonella henselae（13, henselae） and Bartonella Quintana （B. quintana ） IgG antibod- ies were tested by indirect immunofluorescence assay （IFA）. Results Totally, sera from 232 patients with FUO were tested. The infection rate of B. henselae （30.17 % ） was higher than those of B. quintana （ 18.10 % ） and leptospirosis （4.74 % ）. The mixed infection rate of B. henselae and B. quintana （14.22%） was higher than that of leptospirosis and B. henselae （2.16%）, as well as that of leptospirosis and B. quintana （0.86%）. One case had antibodies for leptospirosis, B. henselae and B. quintana. Conclusions Some patients with FUO are actually infected with leptospirosis, and/or Bartonella henselae and/or Bartonella quintana. The infection rates are different, and mixed infection is common. It is necessary to carry out lepto- spirosis and bartonella screening to diagnose fever of unknown origin.

关 键 词：不明原因发热 钩端螺旋体 汉塞巴尔通体 五日热巴尔通体 

分 类 号：R441.3[医药卫生—诊断学]