A tick bite patient with fever and meningitis co-infected with Rickettsia raoultii and Tacheng tick virus 1: a case report.
A tick bite patient with fever and meningitis co-infected with Rickettsia raoultii and Tacheng tick virus 1: a case report.
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DOI：
10.1186/s12879-021-06877-z
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发表时间：
2021-11-25
影响因子：
3.7
通讯作者：
Wang Y
中科院分区：
文献类型：
--
作者：
Zhang Y;Jiang L;Yang Y;Xie S;Yuan W;Wang Y
越来越多的扁虱传播的病原体被发现，包括那些感染人类的病原体。然而，关于由两种或两种以上扁虱传播的病原体引起的联合感染的报告很少。一名38岁的男性农民被硬虱叮咬，出现发烧(37.7摄氏度)、剧烈头痛和呕吐的症状。腰椎穿刺术在卧位外侧进行。脑脊液透明，分析显示重度增压(320mMH2O)，轻度白细胞增多(126.0 × 10~6/L，单核细胞占73%)，总蛋白浓度升高(0.92g/L)。脑脊液和血液细菌培养均为阴性。通过从患者血液中扩增4个立克次体遗传标志物和TcTV-1的部分小片段(S)，确诊为拉氏立克次体和塔城硬蜱病毒1(TcTV-1)的混合感染。患者经左氧氟沙星和利巴韦林治疗后逐渐恢复。这是首例报告的由罗氏杆菌和TcTV-1引起的发烧和脑膜炎混合感染病例。在扁虱咬伤患者中筛查多种病原体至关重要，特别是在那些具有严重复杂症状的患者中。
Increasing numbers of tick-borne pathogens are being discovered, including those that infect humans. However, reports on co-infections caused by two or more tick-borne pathogens are scarce. A 38-year-old male farmer was bitten by a hard tick, presented with fever (37.7 °C), severe headache and ejection vomiting. Lumbar puncture was performed in the lateral decubitus. The cerebrospinal fluid (CSF) was clear, and analysis showed severe increased pressure (320 mm H2O), mild leukocytosis (126.0 × 106/L, mononuclear cells accounting for 73%) and elevated total protein concentration (0.92 g/L). Bacterial cultures of CSF and blood were negative. The diagnosis of Rickettsia raoultii and Tacheng tick virus 1 (TcTV-1) co-infection was confirmed by amplifying four rickettsial genetic markers and the partial small (S) RNA segment of TcTV-1 from the patient’s blood. The patient gradually recovered after treatment with levofloxacin and ribavirin. This is the first reported co-infection case with fever and meningitis caused by R. raoultii and TcTV-1. It is vital to screen for multiple pathogens in tick-bitten patients, especially in those with severe complex symptoms.