海南2例少见布鲁菌感染患者的诊疗

Diagnosis and treatment of two cases of rare Brucella infection in Hainan

本文报道了检验医师参与海南地区2例布鲁菌感染患者的诊断、治疗和疗效评价。两例患者均出现畏寒、发热现象,其中一例伴有四肢乏力、食欲不振,另一例伴有明显头痛。血培养革兰染色镜检见革兰阴性短小杆菌,呈"细沙样",柯氏染色待检菌为阳性(红色),大肠埃希菌为阴性(蓝色),15 min尿素酶强阳性,具备布鲁菌感染的特点。血清试管凝集试验(SAT)效价分别为1∶200及1∶1 600。考虑到患者曾有牛羊接触史,结合发病特征及实验室检查,确诊为布鲁菌病。经利福平(600 mg/d)联合多西环素(200 mg/d)正规治疗6周后患者恢复良好。

The diagnosis, treatment and efficacy evaluation of 2 cases of Brucella infection in Hainan were reported. Both patients suffered from cold and fever, one of which was accompanied by weak limbs, inappetite and another obvious headache.The Gram stain microscopy showed gram negative short bacillus with characteristic of fine sand. Appearance of distinct red color in Kovac＇s reagent upper layer is the positive test, and Escherichia coli was negative（blue）, urease for 15 minutes was positive, which conforms to the characteristics of Brucella infection. The serum tube agglutination test（SAT） was 1∶200 and 1∶1 600 respectively. Considering the patient＇s history of cattle and sheep exposure, based on the pathogenesis and laboratory tests, they were diagnosed with brucellosis. The patients recovered well after 6 weeks of regular treatment with rifampicin（600 mg/d） and doxycycline（200 mg/d）.