mNGS诊断急性Q热二例并文献复习
Two Cases of Acute Q Fever Diagnosed by mNGS and Literature Review
DOI: 10.12677/ACM.2023.1371682, PDF,    科研立项经费支持
作者: 罗 娇, 和 倩, 黄丽华, 顾 伟：大理大学第一附属医院感染病科，云南 大理；蒲艳琳, 陈会桥：福贡县人民医院内科，云南 福贡；朱元昭*：大理大学第一附属医院老年病科，云南 大理
关键词: Q热；贝纳柯克斯体；mNGS；血培养阴性；Q Fever； Coxiella burnetii； mNGS； Blood Culture Negative
摘要: 目的：加深临床医师对急性Q热的认识，减少慢性Q热的发生。方法：对我院在2023年2月~3月经mNGS诊断的2例急性Q热的临床表现、实验室特点总结分析并进行文献复习。结果：2例患者均主要表现为不明原因发热，2例均出现肝功能异常、D-二聚体升高、降钙素原升高；血培养、肺CT均无异常。2例均经mNGS确诊，并经多西环素或四环素规范治疗，病情好转。结论：急性Q热国外发病率高，但国内报道不多，纠其原因可能是其无特异性临床表现及常规病原学培养阴性，临床中容易误诊漏诊。mNGS可快速提供诊断证据，考虑其检查费用昂贵，偏远地区如遇不明原因发热且无法完善mNGS检查，可试用四环素类治疗。
Abstract: Objective: To deepen clinicians’ understanding of acute Q fever and reduce the occurrence of chron-ic Q fever. Methods: The clinical manifestations and laboratory characteristics of 2 cases of acute Q fever diagnosed with mNGS in the First Affiliated Hospital of Dali University from February to March 2023 were summarized and analyzed, and the literature was reviewed. Results: The main manifes-tations of the two patients were fever of unknown cause, abnormal liver function, D- dimer and pro-calcitonin. Blood culture and lung CT showed no abnormality. Both cases were confirmed by mNGS and treated with doxycycline or tetracycline. Conclusion: The incidence of acute Q fever is high abroad, but there are few reports in China. The reason may be that the acute Q fever has no specific clinical manifestations and routine etiological culture is negative, so it is easy to misdiagnose and miss diagnosis in clinical practice. mNGS can provide rapid diagnostic evidence. Considering the high cost of testing, in remote areas where there is unexplained fever and the testing of mNGS can-not be improved, ciscycline therapy can be used.
文章引用：罗娇, 和倩, 黄丽华, 顾伟, 蒲艳琳, 陈会桥, 朱元昭. mNGS诊断急性Q热二例并文献复习[J]. 临床医学进展, 2023, 13(7): 12005-12011. https://doi.org/10.12677/ACM.2023.1371682

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