BACKGROUND Q fever myocarditis is a rare disease manifestation of Q fever infection caused by Coxiella burnetii.It is associated with significant morbidity and mortality if left untreated.Prior studies have reported m...BACKGROUND Q fever myocarditis is a rare disease manifestation of Q fever infection caused by Coxiella burnetii.It is associated with significant morbidity and mortality if left untreated.Prior studies have reported myocarditis in patients with acute Q fever.We present the first case of chronic myocarditis in an end-stage heart failure patient with chronic Q fever infection.CASE SUMMARY A 69-year-old male was admitted with dyspnea on exertion,hypotension and bilateral lower extremity edema for a few months.He has a past medical history of ischemic cardiomyopathy with left ventricular ejection fraction of 25%,implantable cardioverter defibrillator in place,bioprosthetic aortic valve and mitral valve replacement.He continued to have shortness of breath despite diuresis along with low grade fevers.Initial infectious work up came back negative.On further questioning,the patient was found to have close contact with farm animals and the recurrent fevers prompted the work-up for Q fever.Q fever serologies and cardiac positron emission tomography confirmed the diagnosis of chronic Q fever myocarditis.He was then successfully treated with doxycycline and hydroxychloroquine for 18 mo.CONCLUSION Chronic Q fever myocarditis,if left untreated,carries a poor prognosis.It should be kept in differentials,especially in patients with recurrent fevers and contact with farm animals.展开更多
目的 分析登革热（DF）患者血小板输注有效性及合理性。方法 回顾性分析本院2014年住院的805名登革热患者的临床资料及相关检验室数据,根据患者伴慢性病情况分为DF伴心脑血管疾病组（n=475）、DF伴其他慢性疾病组（n=229）和DF无伴慢性...目的 分析登革热（DF）患者血小板输注有效性及合理性。方法 回顾性分析本院2014年住院的805名登革热患者的临床资料及相关检验室数据,根据患者伴慢性病情况分为DF伴心脑血管疾病组（n=475）、DF伴其他慢性疾病组（n=229）和DF无伴慢性疾病组（n=101）;按照患者极期Plt（×10^9/L）最低值情况分为最低〉100组（n=78）,最低50-100组（n=375）和最低〈50组（n=352）;依据患者是否输注血小板,分为输注组（n=81）和非输注组（n=271）,将输注血小板患者按其输注前的Plt（×10^9/L）値,分〈20组（n=58）和≥20组（n=23）。依据各组患者输注血小板前后的Plt、对患者血小板输注指征、病程及输注血小板情况做统计分析。结果 1）极期不同Plt（×10^9/L）最低值患者病程〉100组与50-100组为：7.1±1.2 vs 8.5±1.9（P〉0.05）,〈50组为13.8±6.1（P〈0.05）。2）输注组和非输注2组DF患者Plt从极期最低值回升至100的恢复时间（d）分别为：5.2±1.1 vs 5.1±3.2（P〉0.05）;病程（d）分别为：9.2±4.3 vs 8.9±4.5（P〉0.05）。3）极期DF患者Plt（×10^9/L）平均输注量（U）〈20组和≥20组分别为1.2±0.3 vs 2.1±0.2（P〈0.05）;出血率分别为5.2%（3/58）vs 4.3%（1/23）（P〉0.05）;输血反应过敏反应、发热率分别为6.9%（4/58）vs 10.3%（6/58）vs 13.0%（3/23）17.4%（4/23）（P〈0.05）;输注无效发生率为5.2%（3/58）vs 4.3%（1/23）（P〉0.05）。结论 DF患者血小板减少的程度与感染的严重程度相关,输注血小板对患者血小板恢复和病程无影响。展开更多
文摘BACKGROUND Q fever myocarditis is a rare disease manifestation of Q fever infection caused by Coxiella burnetii.It is associated with significant morbidity and mortality if left untreated.Prior studies have reported myocarditis in patients with acute Q fever.We present the first case of chronic myocarditis in an end-stage heart failure patient with chronic Q fever infection.CASE SUMMARY A 69-year-old male was admitted with dyspnea on exertion,hypotension and bilateral lower extremity edema for a few months.He has a past medical history of ischemic cardiomyopathy with left ventricular ejection fraction of 25%,implantable cardioverter defibrillator in place,bioprosthetic aortic valve and mitral valve replacement.He continued to have shortness of breath despite diuresis along with low grade fevers.Initial infectious work up came back negative.On further questioning,the patient was found to have close contact with farm animals and the recurrent fevers prompted the work-up for Q fever.Q fever serologies and cardiac positron emission tomography confirmed the diagnosis of chronic Q fever myocarditis.He was then successfully treated with doxycycline and hydroxychloroquine for 18 mo.CONCLUSION Chronic Q fever myocarditis,if left untreated,carries a poor prognosis.It should be kept in differentials,especially in patients with recurrent fevers and contact with farm animals.
文摘目的 分析登革热（DF）患者血小板输注有效性及合理性。方法 回顾性分析本院2014年住院的805名登革热患者的临床资料及相关检验室数据,根据患者伴慢性病情况分为DF伴心脑血管疾病组（n=475）、DF伴其他慢性疾病组（n=229）和DF无伴慢性疾病组（n=101）;按照患者极期Plt（×10^9/L）最低值情况分为最低〉100组（n=78）,最低50-100组（n=375）和最低〈50组（n=352）;依据患者是否输注血小板,分为输注组（n=81）和非输注组（n=271）,将输注血小板患者按其输注前的Plt（×10^9/L）値,分〈20组（n=58）和≥20组（n=23）。依据各组患者输注血小板前后的Plt、对患者血小板输注指征、病程及输注血小板情况做统计分析。结果 1）极期不同Plt（×10^9/L）最低值患者病程〉100组与50-100组为：7.1±1.2 vs 8.5±1.9（P〉0.05）,〈50组为13.8±6.1（P〈0.05）。2）输注组和非输注2组DF患者Plt从极期最低值回升至100的恢复时间（d）分别为：5.2±1.1 vs 5.1±3.2（P〉0.05）;病程（d）分别为：9.2±4.3 vs 8.9±4.5（P〉0.05）。3）极期DF患者Plt（×10^9/L）平均输注量（U）〈20组和≥20组分别为1.2±0.3 vs 2.1±0.2（P〈0.05）;出血率分别为5.2%（3/58）vs 4.3%（1/23）（P〉0.05）;输血反应过敏反应、发热率分别为6.9%（4/58）vs 10.3%（6/58）vs 13.0%（3/23）17.4%（4/23）（P〈0.05）;输注无效发生率为5.2%（3/58）vs 4.3%（1/23）（P〉0.05）。结论 DF患者血小板减少的程度与感染的严重程度相关,输注血小板对患者血小板恢复和病程无影响。
