دورية أكاديمية
أعرض في EDS

mNGS helped diagnose scrub typhus presenting as a urinary tract infection with high D-dimer levels: a case report.

التفاصيل البيبلوغرافية
العنوان: mNGS helped diagnose scrub typhus presenting as a urinary tract infection with high D-dimer levels: a case report.
المؤلفون: Liu MF; Department of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, People's Republic of China., Liu Y; Department of Emergency, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, People's Republic of China., Xu DR; Department of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, People's Republic of China., Wan LG; Department of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, People's Republic of China. WLGME196412@126.com., Zhao R; Department of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, People's Republic of China. zhaoruisc@163.com.
المصدر: BMC infectious diseases [BMC Infect Dis] 2021 Dec 07; Vol. 21 (1), pp. 1219. Date of Electronic Publication: 2021 Dec 07.
نوع المنشور: Case Reports; Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100968551 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2334 (Electronic) Linking ISSN: 14712334 NLM ISO Abbreviation: BMC Infect Dis Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Orientia tsutsugamushi*/genetics , Scrub Typhus*/diagnosis , Scrub Typhus*/drug therapy , Urinary Tract Infections*/diagnosis, Female ; Fibrin Fibrinogen Degradation Products ; High-Throughput Nucleotide Sequencing ; Humans ; Metagenomics ; Middle Aged
مستخلص: Background: Scrub typhus is caused by O. tsutsugamushi and spreads through mite larvae biting the skin. Classic symptoms of the disease are eschar and lymphadenopathy. Previous reports have revealed clinical manifestations of scrub typhus, including gastrointestinal symptoms, meningoencephalitis, ocular flutter, pneumonitis, acute respiratory distress syndrome, and acute kidney injury. However, cases of scrub typhus presenting as a urinary tract infection (UTI) with high D-dimer levels could be easily misdiagnosed when clinical attention is insufficient, resulting in difficulty in making a timely diagnosis of the infection. Metagenomics next-generation sequencing (mNGS) is a revolutionary and highly sensitive method that may help in diagnosing atypical cases, even when trace amounts of pathogens are present.
Case Presentation: A 52-year-old female presented with a 10-day history of fever, chills, headache and myalgia. She was initially diagnosed with influenza at a local clinic. Various antibacterials were used on the 2nd-12th day onwards; however, her symptoms persisted and were followed by increased urination duration, frequency, urgency and dysuria for 2 days. Orientia tsutsugamushi was confirmed as the pathogen responsible for the infection through mNGS analysis of her blood samples from Day 13 onwards. The patient's temperature changed remarkably 24 h after the initiation of doxycycline. Over the next 48 h (i.e., Day 15 onwards), the patient showed clinical improvement. She recovered and was discharged from the hospital.
Conclusions: Scrub typhus can present atypical clinical symptoms, such as UTIs, in a febrile patient. mNGS may be a useful method for identifying O. tsutsugamushi infection in patients with atypical clinical manifestations.
(© 2021. The Author(s).)
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معلومات مُعتمدة: 20192BAB205088 Natural Science Foundation of Jiangxi Province; 180120 Natural Science Foundation of Jiangxi Province Department of Education
فهرسة مساهمة: Keywords: Metagenomics next-generation sequencing; O. tsutsugamushi; Scrub typhus; Urinary tract infection
المشرفين على المادة: 0 (Fibrin Fibrinogen Degradation Products)
0 (fibrin fragment D)
تواريخ الأحداث: Date Created: 20211208 Date Completed: 20211209 Latest Revision: 20211214
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC8650249
DOI: 10.1186/s12879-021-06889-9
PMID: 34876034
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2334
DOI:10.1186/s12879-021-06889-9