Case Report: A Cluster of Three Leptospirosis Cases in a New York City Abattoir and an Unusual Complication in the Index Case
Case Report: A Cluster of Three Leptospirosis Cases in a New York City Abattoir and an Unusual Complication in the Index Case
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DOI：
10.4269/ajtmh.17-0545
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发表时间：
2017-01-01
影响因子：
3.3
通讯作者：
Eckhardt, Benjamin J.
中科院分区：
文献类型：
--
作者：
Kupferman, Tania;Coffee, Megan P.;Eckhardt, Benjamin J.
我们报告一例46岁男性屠宰场工人谁开发肌痛，呼吸急促，烦躁2周后，持续割伤的手在工作中用刀。在医院对感染性休克进行评估期间，发现他发热、水肿、严重黄疸伴无菌性脑膜炎和肾衰竭，并经血清和尿液聚合酶链反应确诊为问号钩端螺旋体感染。经过标准的抗生素治疗和严重的临床疾病恢复后，他患上了单侧睾丸炎，继发于钩端螺旋体病的脓尿，这是兽医文献中公认的并发症，但我们在英文文献中首次报道了人类的并发症。该病例也是2016-2017年冬季在纽约市发现的钩端螺旋体病聚集性暴发的指示病例，涉及在屠宰场一个街区内生活或工作的总共3名患者。两名患者存活，而第三名患者在寻求医疗护理后不久死于肺出血。
We report the case of a 46-year-old male abattoir worker who developed myalgias, shortness of breath, and irritability 2 weeks after sustaining a laceration to the hand with a knife at work. During his hospital evaluation for septic shock he was noted to be febrile, hypotensive, profoundly jaundiced with aseptic meningitis, and renal failure, and was diagnosed with Leptospirosis interrogans infection confirmed by serum and urine polymerase chain reaction. After standard antibiotic therapy andrecovery from severe clinical illness, he developed unilateral orchitis with pyuria secondary to leptospirosis, a well-established complication in the veterinary literature, but of which we offer the first report in humans in the English literature. The case presented was also the index case that uncovered a cluster outbreak of leptospirosis in New York City during the winter of 2016-2017, involving a total of three patients who lived or worked within a block of the abattoir. Two patients survived whereas the third died of pulmonary hemorrhage shortly after seeking medical care.