恙虫病合并多器官功能障碍综合征

Scrub typhus complicated with multiple organ dysfunction syndrome

41岁男性患者,野外徒步活动后持续发热,右侧前臂出现焦痂,多种广谱抗生素疗效均不佳,继之出现血小板减低、肝酶和胆红素升高、少尿、胸闷,接受连续性肾脏替代治疗。通过宏基因组二代测序从血液中检测出恙虫病东方体基因序列,确诊为恙虫病。调整为多西环素治疗后体温正常,血小板上升,肝酶、胆红素下降,肾功能恢复正常。

A 41-year-old male patient presented with persistent fever and right forearm eschar after hiking with poor response to a variety of broad spectrum antibiotics, followed by thrombocytopenia, elevated transaminase and bilirubin, oliguria, and chest distress, received continuous renal replacement therapy. The gene sequence of orientia tsutsugamushi was detected by metagenomic next-generation sequencing in the blood of the patient and confirm the diagnosis of scrub typhus.After doxycycline treatment, the temperature was normal, platelets increased, transaminase and bilirubin decreased, and renal function recovered to normal.