BACKGROUND Scrub typhus is an acute infectious disease caused by rickettsia infection.The diagnosis is based on eschar,and clinical manifestations can range from asymptomatic to multiorgan dysfunction.CASE SUMMARY We ...BACKGROUND Scrub typhus is an acute infectious disease caused by rickettsia infection.The diagnosis is based on eschar,and clinical manifestations can range from asymptomatic to multiorgan dysfunction.CASE SUMMARY We report the case of a 35-year-old man living in Zhuhai,Guangdong,China,who had repeated high fever with a maximum body temperature of 40.2°C and elevated white blood cells and procalcitonin levels.After 7 d of persistent high fever,the patient developed rash,abdominal pain,and symptoms of peritonitis.Within 24 h after admission,the patient developed diffuse peritonitis and pneumonedema,requiring ventilator support in the intensive care unit.However,there was no eschar on the body,and the first Weil-Felix test was negative.Taking into account that the patient had a history of jungle activities,doxycycline combined with meropenem was selected.The patient improved,healed,and was discharged after a week.The diagnosis of scrub typhus was confirmed by a repeat Weil-Felix test(Oxk 1:640),and pathology of the appendix resected by laparotomy suggests vasculitis.CONCLUSION This rare presentation of peritonitis,pulmonary edema,and pancreatitis caused by scrub typhus reminds physicians to be alert to the possibility of scrub typhus.展开更多
Aim To simulate the condition when people travel to the plateau. To make a primary investigation about the mice models, which are respectively provoked by exhaustive exercise, cold and fatigue, and epinephrine. Method...Aim To simulate the condition when people travel to the plateau. To make a primary investigation about the mice models, which are respectively provoked by exhaustive exercise, cold and fatigue, and epinephrine. Methods Divide the Kunming mice into 8 groups in random, with 10 in a single group, control group in plain; exhaustive exercise group in plain; fatigue ＆ cold group in plain; epinephrine stimulating group in plain; control group in plateau; exhaustive exercise group in plateau; fatigue ＆ cold group in plateau; epinephrine stimulating group in plateau. To simulate the condition when people travel to Lhasa whose altitude reaches 3700m, those mice were carried there during a five-day period. Day 1： Weight the mice after fasting for 12hrs, then treated different with corresponding methods. Day 2： Collect the data of mortality in each group and sacrifice the alive. Weight the cardiac, pulmonary and cerebral tissues and calculate for the Viscera Index. Results After the journey to the plat- eau, the weight of mice decreases significantly, in exhaustive exercise group and fatigue ＆ cold group also with the increase of pulmonary and cerebral index and decrease of cardiac index compared with groups in plain. As for those who are stimulated with epinephrine, the ones in plateau suffer more from pneumonedema but have a longer life span. The sensitivity to epinephrine can decrease in female mice in plateau, which can be reversed in plain. Con- clusions After the journey to plateau, acute plateau pneumonedema and cerebral edema can be provoked by ex- haustive exercise, fatigue and cold, and starvation; The severity of pneumonedema caused by epinephrine are relat- ed to the environment, strength and gender.展开更多
基金Supported by the National Key Research and Development Program of China,No.2016YFC1301202.
文摘BACKGROUND Scrub typhus is an acute infectious disease caused by rickettsia infection.The diagnosis is based on eschar,and clinical manifestations can range from asymptomatic to multiorgan dysfunction.CASE SUMMARY We report the case of a 35-year-old man living in Zhuhai,Guangdong,China,who had repeated high fever with a maximum body temperature of 40.2°C and elevated white blood cells and procalcitonin levels.After 7 d of persistent high fever,the patient developed rash,abdominal pain,and symptoms of peritonitis.Within 24 h after admission,the patient developed diffuse peritonitis and pneumonedema,requiring ventilator support in the intensive care unit.However,there was no eschar on the body,and the first Weil-Felix test was negative.Taking into account that the patient had a history of jungle activities,doxycycline combined with meropenem was selected.The patient improved,healed,and was discharged after a week.The diagnosis of scrub typhus was confirmed by a repeat Weil-Felix test(Oxk 1:640),and pathology of the appendix resected by laparotomy suggests vasculitis.CONCLUSION This rare presentation of peritonitis,pulmonary edema,and pancreatitis caused by scrub typhus reminds physicians to be alert to the possibility of scrub typhus.
文摘Aim To simulate the condition when people travel to the plateau. To make a primary investigation about the mice models, which are respectively provoked by exhaustive exercise, cold and fatigue, and epinephrine. Methods Divide the Kunming mice into 8 groups in random, with 10 in a single group, control group in plain; exhaustive exercise group in plain; fatigue ＆ cold group in plain; epinephrine stimulating group in plain; control group in plateau; exhaustive exercise group in plateau; fatigue ＆ cold group in plateau; epinephrine stimulating group in plateau. To simulate the condition when people travel to Lhasa whose altitude reaches 3700m, those mice were carried there during a five-day period. Day 1： Weight the mice after fasting for 12hrs, then treated different with corresponding methods. Day 2： Collect the data of mortality in each group and sacrifice the alive. Weight the cardiac, pulmonary and cerebral tissues and calculate for the Viscera Index. Results After the journey to the plat- eau, the weight of mice decreases significantly, in exhaustive exercise group and fatigue ＆ cold group also with the increase of pulmonary and cerebral index and decrease of cardiac index compared with groups in plain. As for those who are stimulated with epinephrine, the ones in plateau suffer more from pneumonedema but have a longer life span. The sensitivity to epinephrine can decrease in female mice in plateau, which can be reversed in plain. Con- clusions After the journey to plateau, acute plateau pneumonedema and cerebral edema can be provoked by ex- haustive exercise, fatigue and cold, and starvation; The severity of pneumonedema caused by epinephrine are relat- ed to the environment, strength and gender.
