多西环素治疗急性Q热失败1例

A case of failure in the treatment of acute Q fever with doxycycline

摘要:

Q热是由伯氏考克斯氏体引起的一种世界范围内高致病性的人畜共患疾病。Q热临床表现不典型, 常规实验室及影像学检查缺乏特异性, 多数患者症状轻微且可自愈。Q热不是我国法定传染病, 国内缺乏相关的诊治指南, 是一种长期以来被忽视和诊断不足的疾病。本文报告1例病例, 通过血液宏基因组二代测序(mNGS)诊断为急性Q热, 经14 d多西环素治疗发热不退, 后经米诺环素治疗3 d病情好转, 旨在提高临床医生对急性Q热的认识, 缩短疾病诊治时间。

Abstract:

Q fever is a highly pathogenic zoonotic disease caused by Coxiella burneti worldwide. Clinical manifestations of Q fever are atypical, and routine laboratory and imaging examinations lack specificity. Most patients have mild symptoms that can self-resolve. Q fever is not a notifiable infectious disease in China. There is a lack of relevant diagnosis and treatment guidelines, making it a long-neglected and underdiagnosed disease. This article reports a case of acute Q fever diagnosed by metagenomic next-generation sequencing (mNGS) of blood specimen, who did not respond to 14 days treatment with doxycycline, condition improved after being treated with minocycline for 3 days. The article aims to improve the awareness of acute Q fever among clinicians and shorten the time of diagnosis and treatment.