Acute Q fever with Secondary Hemophagocytic Syndrome: Case Report and Literatures Review

急性Q熱合併續發性噬血症候群：病例報告與文獻回顧

陳昶華(Chang-Hua Chen) ； 鍾智淵(Chih-Yuan Chung)

《內科學誌》 26卷6期 (2015/12) Pp. 363-368

https://doi.org/10.6314/JIMT.2015.26(6).08

摘要

噬血症候群，是急性Q熱罕見的一種嚴重的併發症。我們報告一例３１歲的男性，發生發燒，畏寒，頭痛，咳嗽，與血小板低下，依照Henter標準疾病吻合的嗜血症候群的診斷，並且血清學確認是急性Q熱。在doxycycline治療反應不佳情形下，病患接受14天的levofloxacin治療後，順利康復出院。我們建議，急性Q熱病患出現血液學異常的現象需要將噬血症候群列入鑑別診斷，此外，在doxycycline治療反應不佳情形下，fluoroquinolones可以考慮為替代性治療。

並列摘要

Hemophagocytic syndrome (HPS) is a rare and severe complication of acute Q fever. We describe one case of HPS in a 31-year-old man with fever, severe headache, and progressive thrombocytopenia. His condition met the modified Henter's criteria for HPS, and indirect immunofluorescence assay for Coxiella burnetii showed seroconversion with high titers of phase II IgM & IgG antibodies in convalescent serum. He received a 14-day course of levofloxacin because he had no response to doxycycline. This case suggests that HPS should be considered when hematological abnormalities develop in patients with acute Q fever, and that fluoroquinolones are an alternative therapy for doxycycline-refractory Q fever.

並列關鍵字

Acute Q fever ； Hemophagocytic syndrome ； Fluoroquinolone