阜阳市附红细胞体病感染情况分析

目的了解阜阳市附红细胞体(附红体)的感染情况。方法以涂片染色法、压片镜检法等,对阜阳市所辖范围内包括健康人、病人在内的人群及包括家畜(禽)、鼠在内的动物,进行附红体感染情况的调查。结果检查1301人,阳性442例,阳性率33．97%。其中服务员、工人、学生、奶牛饲养员、病人的阳性率分别为:27．55%、19．39%、31．15%、90．91%和47．63%。检查 467只(头)动物,阳性率44．11%。其中猪、奶牛、鸡、鼠的阳性率分别为49．20%、95．55%、 26．51%和5．00%。对12例确诊重型附红体病病人选用庆大霉素、四环素族、喹诺酮类,甲硝唑中的二种药物并用或选用口服加静脉途径用药,取得显著的疗效。结论阜阳市人畜间广泛存在附红体感染。今后应进一步开展附红体病的病原学、流行病学、诊断及治疗的研究。     

100例献血员附红细胞体病的感染分析

１００例献血员附红细胞体病的感染分析李凤英，赵京文，吕春兰，丽娜，王莉萍为了研究献血员附红细胞体病（Ｅｐｅｒｙｔｈｒｏ－ｚｏｏｎｏｓｉｓ，ＥｐＥ）的感染情况，摸清附红细胞体病的传播规律，以便在输血中采取有效的防治措施，我们选择呼和浩特市郊区等１００例...     

人感染疑似猪附红细胞体六例报道

目的 探讨人体感染猪附红细胞体实验室检测与临床症状的关系。方法 检测与病猪接触的6名饲养员的体温、X光胸片、血常规、血细胞形态分析、红细胞脆性试验、网织红细胞计数、肝肾功能、外斐试验、Coombs试验、血清免疫球蛋白浓度、尿含铁血黄素及附红细胞体。结果 6名饲养员的外周血均有不同程度的附红细胞体感染，红细胞感染率高的2名饲养员出现发热、贫血、网织红细胞计数升高、红细胞脆性增高、尿含铁血黄素阳性。所有饲养员肝肾功能、Coombs试验、外斐试验和血清免疫球蛋白未见异常。结论 附红细胞体病的临床症状与红细胞感染率相关，加强附红细胞体的检测对诊断不明原因的贫血、发热等有积极的作用。     

小儿附红细胞体的检验与鉴定—附一例报道

小儿附红细胞体的检验与鉴定—附一例报道裴标，高峻，刘玉娥，陶墨奎（江苏省阜宁县卫生防疫站，江苏阜宁２２４４００）附红细胞体（Ｅｐｅｒｙｔｈｒｏｚｏｏｎ）是引起人及动物附红细胞体病（Ｅｐｅｒｙｔｈｒｏｚｏｏｎｏｓｉｓ）的一种单细胞原生动物［１］。自１９...     

人感染疑似猪附红细胞体六例报道

目的探讨人体感染猪附红细胞体实验室检测与临床症状的关系。方法检测与病猪接触的6名饲养员的体温、X光胸片、血常规、血细胞形态分析、红细胞脆性试验、网织红细胞计数、肝肾功能、外斐试验、Coombs试验、血清免疫球蛋白浓度、尿含铁血黄素及附红细胞体。结果6名饲养员的外周血均有不同程度的附红细胞体感染,红细胞感染率高的2名饲养员出现发热、贫血、网织红细胞计数升高、红细胞脆性增高、尿含铁血黄素阳性。所有饲养员肝肾功能、Coombs试验、外斐试验和血清免疫球蛋白未见异常。结论附红细胞体病的临床症状与红细胞感染率相关,加强附红细胞体的检测对诊断不明原因的贫血、发热等有积极的作用。     

2例人感染附红体病的护理体会

附红细胞体病(Epeyrthrozoonsis,简称附红体病)是由附红细胞体(Eperythrozoon,简称附红体),附红体属立克次体目(附红体宿主有绵羊、山羊、牛、猪、马、驴、骡、狗、猫、兔、鼠、蠓、鸟类和人等)感染机体后,寄生于人或动物红细胞表面、血浆及骨髓等处,引起的人兽共患病,以发热(39~40℃)、贫血和黄疸等为主要临床表现[1,2]。严重者可出现代谢紊乱、酸碱失衡、低血糖等[3-5]。2006年8月我科收治了2例姐弟同时感染“附红体”的病例,经过精心的治疗和护理,取得较好疗效,现将护理体会报告如下。1病例简介病例1:患儿,女,8岁,反复发热28d,发现肝脾…     

附红细胞体病

在我国附红细胞体病是近十几年来才发现的一种人畜共患疾病,其主要传染源是以羊等为主的各种动物;其病原体可能是原虫或立克次氏体。1981年前后,我国曾在江苏、宁夏等地的家兔、马、驴、牛、羊如人血液中发现,1983年曾从5份人血液中查到附红细胞体,1987年南京等地发现了人附红细胞体病例,最近北京协和医院又发现病例。目前世界上已有20多个国家有此病报告。为了防止此病在我国流行蔓延,我刊特发表此文,以引起有关部门的重视。建议有关单位加强研究,安排必要的流行病学调查,尽早制订出有效的防治措施。     

附红细胞体病误诊为骨髓增生异常综合征一例

附红细胞体病（eperythrogoonosis）是由附红细胞体感染机体而引起的人畜共患传染病，容易误诊，本院收治1例，曾被误诊为肝硬化、骨髓增生异常综合征。[第一段]     

人附红体病1例附文献复习

目的 了解人附红体病的研究现状,提出预防和诊治需要注意的问题.方法 通过外周血涂片镜检等方法诊断病例,分析本病例的诊治经过,以及对国内外相关研究成果汇总分析.结果 根据患者各项检查,以及治疗后回顾病例,结合其他相关附红体病文献资料,诊断附红体病.结论 作为一种感染性疾病,附红体病需要引起一定的重视,早期给予相应的治疗,而对于特殊人群更要引起重视.     

人畜共患的附红细胞体病误诊分析

附红细胞体病是一种原虫感染性疾病 ,多见于兽医及在屠宰场工作或有与感染牲畜密切接触史的人 ,该病是一种人畜共患疾病 ,发病率低 ,极易误诊。我科 2 0 0 0年 9月～ 11月诊治 2例均误诊 ,现报告如下。1　病例资料【例 1】　男 ,4 8岁 ,兽医。因发热、关节痛 3个月 ,体温 37 5～ 38 5℃ ,畏寒、出汗、四肢大关节酸痛 ,在当地卫生所按感冒治疗无明显好转 ,来我院就诊。查体 :体温 37 8℃ ,脉搏 84 /ｍｉｎ。皮肤巩膜无黄染 ,浅表淋巴结不大 ,心肺未见异常。肝脾未触及 ,四肢关节无红肿、压痛。实验室检查 :肥达反应、红细胞沉降率、抗链球菌…     

Marked splenomegaly in fetal cytomegalovirus infection: detection supported by three-dimensional power Doppler ultrasound.

An enlarged fetal spleen can be associated with fetal infection, anemia and different syndromes but its prenatal diagnosis is rare. We report on a diagnosis of splenomegaly at 32 weeks' gestation in a fetus which was found to be affected by cytomegalovirus infection. An enlarged spleen was suspected when the stomach was found to be displaced anteriorly and medially and the diagnosis was supported on visualization of the splenic vessels by color and three-dimensional power Doppler ultrasound. The patient had been referred because of fetal growth restriction and intracerebral anomalies and the additional finding of splenomegaly was highly suspicious for cytomegalovirus infection. This was confirmed by positive maternal serology and by neonatal virus excretion in urine. Retrospectively, examination of stored blood samples from 9 and 23 weeks' gestation revealed an early cytomegalovirus infection. Antenatal and neonatal magnetic resonance imaging examinations showed microcephaly, lissencephaly and the presence of microcalcifications. At the age of 9 months, the child suffers from severe neurological impairment and blindness due to severe optical atrophy. This case emphasizes that color Doppler and three-dimensional power Doppler ultrasound can facilitate the antenatal diagnosis of splenomegaly and can help to delineate the spleen from the similar-looking neighboring liver.     

Erythrocyte creatine as a marker of excessive erythrocyte destruction due to hypersplenism in patients with liver cirrhosis

OBJECTIVE: Erythrocyte creatine is a sensitive marker of erythrocyte age, and can be used to detect slight and continuous hemolysis. Excessive blood cell destruction caused by increased spleen function is important evidence of hypersplenism. This study evaluates the usefulness of erythrocyte creatine as a sensitive marker of excessive erythrocyte destruction due to hypersplenism in patients with liver cirrhosis. DESIGN AND METHOD: Erythrocyte creatine was determined by an enzymatic method in 50 patients with postnecrotic liver cirrhosis and 50 healthy controls. The spleen size was measured by ultrasonography and expressed as a spleen index. RESULTS: The patients with splenomegaly showed significantly higher erythrocyte creatine than those without splenomegaly (p < 0.005) and healthy controls (p < 0.001), but there was no significant difference in erythrocyte creatine between healthy controls and those without splenomegaly. Fourteen (93%) of the 15 patients with abnormally high erythrocyte creatine (> 1.8 micromol/g hemoglobin) had splenomegaly. There were no significant differences in reticulocyte count between healthy controls and the patients with and without splenomegaly. Erythrocyte creatine showed good correlations with spleen index (r = 0.67; p < 0.001) and reticulocytes (r = 0.63; p < 0.001). CONCLUSIONS: Erythrocyte creatine can be used for predicting erythropoietic status and estimating hypersplenism in patients with liver cirrhosis.     

骨关节尖端赛多孢菌与偶发分枝杆菌感染实验室诊断和临床治疗

目的　对1例骨关节尖端赛多孢菌与偶发分枝杆菌并发感染病例进行病原学诊断和治疗分析，为临床少见菌感染诊治提供思路。方法　将左大腿及左膝外伤后膝关节红肿骨科住院患者作为研究对象，采集其关节腔积液进行涂片染色、培养及质谱鉴定，根据病原学鉴定结果给予用药指导。结果　患者关节腔引流液外观为脓性乳糜状，涂片抗酸染色见大量白细胞和抗酸阳性呈柴捆状排列菌体；革兰染色见大量白细胞及真菌菌丝；荧光染色见团状菌丝。培养72h后血平板见丝状真菌菌落及细小、干燥的细菌样菌落，质谱仪鉴定为偶发分枝杆菌和尖端赛多孢菌混合感染。给予左氧氟沙星＋伏立康唑＋阿米卡星静脉滴注治疗14天，患者左膝关节肿胀明显减轻，左下肢肌力正常出院。出院医嘱改左氧氟沙星＋多西环素＋伏立康唑口服，因患者经济原因自行停服伏立康唑后复发再次入院，行关节积液培养再次分离出尖端赛多孢菌。临床清创并继续给予左氧氟沙星＋伏立康唑＋阿米卡星静脉滴注治疗，待症状改善后口服左氧氟沙星＋多西环素＋伏立康唑，期间肝功能检测有轻度损害，治疗方案改为口服左氧氟沙星＋复方磺胺甲噁唑＋伏立康唑直至出院，持续治疗6月后患者左膝关节肿胀消失，可自行站立行走，复查血细胞分析、C-反应蛋白、红细胞沉降率及肝肾功能均正常，逐渐停用所有药物。该患者停药后再无复发。结论　骨关节少见菌混合感染应重视实验室涂片检查和病原体鉴定，临床应该结合鉴定结果规范及足疗程治疗是患者治愈的关键。     

卵巢原发性恶性黑色素瘤1例及文献复习

目的 探讨卵巢原发性恶性黑色素的临床病理特征,及其与卵巢转移性肿瘤的鉴别诊断。方法 对１例原发于卵巢囊性畸胎瘤的恶性黑色素瘤标本,通过光镜及免疫组化等方法进行病理组织学观察。结果 组织学特征为：肿瘤细胞大小不等,形态多样,界限不清,呈透明细胞和／或印戒细胞样;瘤细胞内外可见一些粗大的黑色素颗粒,瘤组织内血管较多,核分裂现象多见,〉１０个／１０ＨＰＦ。免疫组化ＨＭＢ４５、Ｖｉｍｅｎｔｉｎ及Ｓ－１００     

Fever, pancytopenia, and splenomegaly 8 months after a trip to Majorca Island (Spain)]

BACKGROUND: Visceral leishmaniasis is a rare imported infectious disease in Germany. Approximately ten to 30 cases are recorded annually. The classic symptoms are often misinterpreted as lymphoma of the spleen. CASE REPORT: A 46-year-old patient presented with fever, malaise, night sweats, pancytopenia, and splenomegaly 8 months after a 2-week trip to Majorca Island (Spain). Bone marrow biopsy showed no evidence of malignant lymphoma. Serology confirmed the suspected clinical diagnosis of visceral leishmaniasis. Cytology and polymerase chain reaction from bone marrow aspirate were positive for Leishmania infantum. Treatment with liposomal amphotericin B was initiated and led to complete recovery. CONCLUSION: Visceral leishmaniasis is an important differential diagnosis for the clinical triad of fever, pancytopenia, and splenomegaly. An accurate travel history is therefore of paramount importance. Without treatment, the case fatality rate is high. A complete recovery is usually achieved with adequate therapy (liposomal amphotericin B, miltefosine).     

T细胞大颗粒淋巴细胞白血病1例报告并文献复习

目的 提高对大颗粒淋巴细胞白血病（LGLL）的认识.方法 对1例T细胞大颗粒淋巴细胞白血病患者的临床资料进行分析,并复习国内外相关文献.结果 T细胞大颗粒淋巴细胞白血病患者常表现为反复感染、脾大、中性粒细胞减少或缺乏和大颗粒淋巴细胞（LGL）增多;外周血、骨髓涂片LGL增多;免疫表型通常为CD3＋、CD4-、CD8＋、CD16＋、CD56-、CD57＋、HLA-DR＋;克隆性TR基因重排;常见染色体异常;排除其他LGLL.结论 T细胞大颗粒淋巴细胞白血病是慢性淋巴细胞白血病中一种少见的较独特类型,必须认真检查,才能避免漏诊误诊,免疫分型检查具有重要价值.     

恙虫病并发中毒性肝炎30例

探讨恙虫病并发中毒性肝炎的临床特点：方法：按诊断标准选择病例进行临床分析。结果；本组除了具有恙虫病特征性的临床表现外，同时出现黄疸占２３％出血点和瘀斑点１３％，肝大占７７％，脾大占６３％。ＡＬＴ和ＡＳＴ升高，平均分别为２９５Ｕ／Ｌ和２４０Ｕ／Ｌ。     

Radiologic diagnosis of wandering spleen complicated by splenic volvulus and infarction

Wandering spleen is a rare condition caused by malattachment of the dorsal mesogastrium. This condition is prone to torsion of the splenic pedicle leading to splenomegaly, hypersplenism, and infarction. Preoperative diagnosis can be suggested radiologically. A case of wandering spleen is reported and its embryologic, clinical, and radiographie features are discussed.     

紫外线照射充氧自血回输疗法治疗慢性活动性乙型肝炎观察

采用紫外线照射充氧自血回输疗法（ＵＢＩＯ）治疗慢性活动性乙型肝炎６０例，治疗４周及８周后治疗组症状、体征改善均优于对照组（Ｐ〈０．０５，Ｐ〈０．０１），总胆红质、谷丙转氨酶及免疫球蛋白下降率差异有非常显著性（Ｐ〈０．０１），总胆红质、谷丙转氨酶在治疗４周或８周恢复正常的例数均高于对照组（Ｐ〈０．０５，Ｐ〈０．０１）。该方法可明显地降低血液粘稠度，改善微循环，增加血氧饱和度，调节免疫功能，并能有效地     

Aggressive natural killer cell leukemia with skin manifestation associated with hemophagocytic lymphohistiocytosis: A case report

BACKGROUNDAggressive natural killer cell leukemia (ANKL) is a rare natural killer cell neoplasm characterized by systemic infiltration of Epstein–Barr virus and rapidly progressive clinical course. ANKL can be accompanied with hemophagocytic lymphohistiocytosis (HLH). Here, we report a case of ANKL with rare skin lesions as an earlier manifestation, accompanied with HLH, and review the literature in terms of etiology, clinical manifestation, diagnosis and treatment.CASE SUMMARYA 30-year-old woman from Northwest China presented with the clinical characteristics of jaundice, fever, erythema, splenomegaly, progressive hemocytopenia, liver failure, quantities of abnormal cells in bone marrow, and associated HLH. The immunophenotypes of abnormal cells were positive for CD2, cCD3, CD7, CD56, CD38 and negative for sCD3, CD8 and CD117. The diagnosis of ANKL complicated with HLH was confirmed. Following the initial diagnosis and supplementary treatment, the patient received chemotherapy with VDLP regimen (vincristine, daunorubicin, L-asparaginase and prednisone). However, the patient had severe adverse reactions and complication such as severe hematochezia, neutropenia, and multiple organ dysfunction syndrome, and died a few days later. CONCLUSIONThis is the first reported case of ANKL with rare skin lesions as an earlier manifestation and associated with HLH.