感染猫立克次体导致重症脑炎1例报告  

Severe encephalitis caused by infection of Rickettsia felis:a case report

作　　者：张丽丽[1] 张俊湖[1] 胡铭[1] 冯勋刚[1] Zhang Lili;Zhang Junhu;Hu Ming;Feng Xungang(Department of Neurology,Affiliated Hospital of Jining Medical University,Jining 272029,Shandong,China)

机构地区：[1]济宁医学院附属医院神经内科,山东济宁272029

出　　处：《中华危重病急救医学》2021年第4期491-493,共3页Chinese Critical Care Medicine

基　　金：山东省自然科学基金(ZR2017LH034)。

摘　　要：猫立克次体是一种专性寄生于细胞内的革兰阴性原核生物,猫蚤是猫立克次体的主要传播媒介。人感染猫立克次体的临床症状包括发热、乏力、头痛、斑状丘疹以及焦痂。目前关于猫立克次体感染引起其他严重并发症或死亡的报道较少。济宁医学院附属医院神经内科2020年1月29日收治1例确诊猫立克次体感染致重症脑炎病例,经阿昔洛韦抗病毒、甘露醇脱水降颅压、人免疫球蛋白调节免疫、盐酸米诺环素胶囊及甲磺酸左氧氟沙星氯化钠抗立克次体感染、控制癫痫发作及肺感染等综合治疗后,患者病情好转出院。通过总结该患者治疗中的经验、教训,以提醒大家加强对猫立克次体感染的认识。Rickettsia felis is a Gram-negative prokaryotic organism that is obligatorically parasitic in cells.Cat fleas are the main vector of Rickettsia felis.Clinical symptoms of human infection with Rickettsia felis include fever,fatigue,headache,macular papules,and eschar.There are few reports of serious complications or deaths due to infection of Rickettsia felis.A confirmed case of severe encephalitis caused by Rickettsia felis infection was admitted to neurology department of Affiliated Hospital of Jining Medical University on January 29,2020.After comprehensive treatment of antiviral by acyclovir,mannitol dehydration to reduce intracranial pressure,human immunoglobulin to regulateimmunity,minocycline hydrochloride capsule,levofloxacin mesylate and sodium chloride against Rickettsia felis infection,control of seizure and pulmonary infection,the patient's condition was improved and then discharged.By summarizing the experience and lessons in the treatment of this patient,we hope to remind everyone to strengthen the understanding of Rickettsia felis infection.

关 键 词：猫立克次体 脑炎 重症 

分 类 号：R742.9[医药卫生—神经病学与精神病学]