A Case of Human Granulocytic Anaplasmosis Suspected to be Complicated by Cholangitis
A Case of Human Granulocytic Anaplasmosis Suspected to be Complicated by Cholangitis
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人粒细胞无形体病疑并发胆管炎一例
DOI：
10.11150/kansenshogakuzasshi.96.29
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
OHASHI Norio
中科院分区：
文献类型：
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作者：
KAWAKAMI Manri;IKEDA Fusao;FUJIOKA Shinichi;FUJITA Hiromi;KIDA Koji;OHASHI Norio
人粒细胞无形体病是一种由嗜吞噬细胞无形体引起的发热性疾病，是一种由蜱传播的细胞内细菌，主要在美国和欧洲流行。日本报告了5例病例。一位63岁的男性因高烧5天而入院。该患者经常在山区工作，并报告说几天前他感到右腿被昆虫叮咬或刺扎。实验室检查显示血清C反应蛋白、总胆红素和肝胆酶水平升高。患者立即开始治疗，并接受米诺环素200 mg/天8天和头孢曲松钠2 g/天6天，以疑似诊断为立克次体病和急性胆管炎，并在8天内恢复。最后，根据蜱传病原体抗体的血清试验结果，发现A.在配对血清中检测到嗜吞噬细胞菌时，患者被诊断为患有无形体病。与先前报告的5例日本病例不同，该患者是一个习惯性饮酒者，怀疑胆管炎是无形体病的并发症。在此，我们报告一个不寻常的介绍和严重的疾病并发症的人粒细胞无形体病的习惯饮酒者。
Human granulocytic anaplasmosis is a febrile illness caused by Anaplasma phagocytophilum, an intracellular bacterium transmitted by ticks that is mainly prevalent in the United States and Europe. Five cases have been reported from Japan. A 63-year-old man was admitted to our hospital with a 5-day history of high fever. The patient frequently worked in mountainous areas and reported having felt an insect bite or thorn stick in his right leg some days earlier. Laboratory investigations showed increased serum levels of C-reactive protein, total bilirubin and the hepatobiliary enzymes. The patient was immediately started on treatment and received minocycline 200 mg/day for 8 days and ceftriaxone sodium 2 g/day for 6 days for a suspected diagnosis of rickettsiosis and acute cholangitis, and recovered by eight days. Eventually, on the basis of the results of serum tests for antibodies to tick-borne pathogens, which revealed increase in antibody titers to A. phagocytophilum in paired sera, the patient was diagnosed as having anaplasmosis. Different from the 5 previously reported cases from Japan, this patient was a habitual drinker and cholangitis was suspected as a complication of anaplasmosis in him. Herein, we report an unusual presentation and severe disease complications of human granulocytic anaplasmosis in a habitual drinker.