Clinical characteristics,diagnosis and treatment of 7 patients with Q fever
Objective To analyze the clinical features of patients with Q fever,summarize its diagnosis and treatment,and promote the recognition of clinical features of this disease.Method The hospitalization data of 7 patients diagnosed with Q fever by metagenomic next-generation sequencing(mNGS)technology in the People's Hospital of Xinjiang Uygur Autonomous Region from July 2021 to February 2024 were retrospectively analyzed,and their common clinical characteristics were summarized.Results A total of 7 patients were enrolled,including 5 males and 2 females,aged 28-68 years old.The duration of hospitalization was 9 to 34 days.The main symptom of 6 cases was fever,1 case had an initial symptom of abdominal distension,accompanied by myalgia,headache,fatigue,chest tightness and dyspnea.3 cases had splenomegaly,1 case presented with enlarged axillary nodes,and 1 case was positive for ascites.Only 1 case had a definite history of residing in the epidemic area.The clinical biochemical results showed that the counts of white blood cells were increased in 1 patient,the percentage of neutrophil was increased in 5 patients,the inflammatory indexes C-reactive protein,procalcitonin were increased in 6 patients,interleukin-6 was increased in 3 patients,and alanine aminotransferase and aspartic transaminase were increased in 5 patients.Imaging examination revealed that 1 case of echocardiography showed the formation of aortic valve neoplasms,1 case of head MRI showed suspicious bilateral pia enhancement with meningoencephalitis,1 case of abdominal B-ultrasonography showed massive ascites,and 1 case of chest CT showed pulmonary inflammation.All the 7 patients were diagnosed with Q fever by mNGS technique,5～3 880 valid sequences of benatcox body were detected,and were treated with doxycycline or combined with meropenem(1 case).Conclusion Q fever lacked specific clinical manifestations and imaging features,and mNGS could provide a better option for the identification of Q fever which was difficult to diagnose.
Q feverMetagenomic next generation sequencing technologyDoxycycline
万方数据
维普
