地方性斑疹伤寒伴发多脏器功能障碍综合征一例

Case of endemic typhus with complication of multiple organ dysfunction syndrome

目的了解地方性斑疹伤寒合并多脏器功能障碍综合征(MODS)的临床特征和治疗情况,以提高对危重型斑疹伤寒的诊治水平。方法回顾性分析本院2015年收治的1例地方性斑疹伤寒合并MODS患者的临床表现及预后,并结合相关文献进行复习。结果研究纳入1例70岁男性地方性斑疹伤寒合并MODS患者,给予多西环素抗炎、丙种球蛋白、血液滤过等治疗后患者神志恢复,尿量增加,腹胀好转,但部分脏器功能进行性恶化,后期出现多脏器功能衰竭而死亡。结论早期应用多西环素及血液滤过对治疗重症斑疹伤寒具有积极作用,但是否应用丙种球蛋白仍需进一步总结经验。

Objective To investigate the clinical features and therapy of endemic typhus with complication of multiple organ dysfunction syndrome（MODS）,and to promote the cognition,diagnosis and treatment of severe typhus.Methods The clinical manifestation and prognosis of one patient with endemic typhus complicated by MODS in our hospital in 2015 were analyzed,retrospectively.The relevant literatures were also reviewed.Results One 70 years old man with endemic typhus,severe MODS complications was enrolled and treated by doxycycline,gamma globulin,hemofiltration,ect.Some organs of the patient partly recovered after treatment.However,his global clinical symptom continued to deteriorate.Lastly,this patients died from multiple organ failure.Conclusions It is important to implement doxycycline and hemofiltration therapy as soon as possible.However,the importance of gamma globulin still need deep investigation.