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NEJM:感染性直肠炎-病例报道

2020-04-23 网络 网络

感染性直肠炎的症状和内窥镜外观可能与炎症性肠病相似。

患者为一名25岁的男子因疲劳,腹痛和排便习惯改变7个月到胃肠病科就诊。他报告有直肠疼痛,出血和里急后重;他最初有腹泻症状,但在就诊前一周出现便秘。他还指出,体重减轻了14公斤,没有盗汗或发热。他报告了有无保护的肛交史。

直肠检查发现肛裂。结肠镜检查显示严重溃疡性直肠炎(如图A所示),活检标本显示活动性直肠炎伴淋巴细胞性炎症。梅毒螺旋体的免疫组织化学染色呈阳性(如图B箭头所示)。快速血浆反应素检测在滴度为1:32时为阳性,而从直肠拭子获得的样品进行聚合酶链反应检查沙眼衣原体L血清型呈阳性,而淋病呈阴性。人类免疫缺陷病毒测试为阴性。该患者被诊断为梅毒和性腺淋巴肉芽肿相关的感染性直肠炎。

感染性直肠炎的症状和内窥镜外观可能与炎症性肠病相似。

该患者接受苄青霉素、阿奇霉素和强力霉素治疗21天,随后症状完全缓解。

原始出处:

Waleed T. Siddiqui,et al.Infectious Proctitis.N Engl J Med 2020;https://www.nejm.org/doi/full/10.1056/NEJMicm1906077

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    2020-04-23 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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