Two cases of brucellosis complicated with liver abscess or pancytopenia / 中华全科医师杂志

Two brucellosis patients with rare complications are presented in this report. In case 1, abdominal CT showed two liver abscesses with the maximum diameter>5.0 cm, no puncture and drainage were given. After treatment with anti brucellosis drugs, the abscess lesions disappeared completely. Case 2 had pancytopenia, the platelet count was reduced to 14×10 9/L. After anti brucellosis drug treatment the peripheral blood routine returned to normal. These two cases of rare complications of brucellosis suggests that early identification, diagnosis and treatment can improve the clinical outcomes of the patients.

The clinical efficacy of metacycline and rifampicin in patients with intractable Brucellosis / 中华地方病学杂志

Objective To analyze the clinical efficacy of metacycline and rifampicin in the patients with refractory brucellosis,and to provide evidence for clinical treatment.Methods From February 2013 to February 2016,sixty-five patients diagnosed refractory brucellosis at the Department of Infectious Diseases,Weifang People's Hospital were enrolled in this study.They were randomly divided into two groups,treatment group (33 cases) and control group (32 cases).Patients of treatment group were treated with metacycline joint rifampicin,and control group was treated with doxycycline hyclate,rifampicin and levofloxacin.After treatment for six weeks,the clinical efficacy and adverse reactions were observed and data were analyzed.Results The effective rate in treatment group (96.97％,32/33) was significantly higher than that in control group (75.00％,24/32,x2 =4.86,P ＜ 0.05).The incidence of gastrointestinal reactions in control group (37.50％,12/32) was much higher than that in treatment group (15.15％,5/33,x2 =4.20,P ＜ 0.05).There were no significant differences between the two groups in the incidence of liver damage,skin rash and leukopenia (x2 =0.49,0.00,1.62,P ＞ 0.05).Conclusion The combined treatment metacycline and rifampicin is safe with high efficiency for patients with refractory brucellosis,and is worthy to be promoted.

Early clinical features of severe cases with hand-foot-mouth disease / 中华全科医师杂志

The clinical features of 120 severe cases with hand-foot-mouth disease (HFMD) were retrospectively analyzed compared with those of the regular cases. Clinical data showed that the age of mostsevere cases ranged from 1-3 years. Sustained high fever ( 55% ) , hypertension ( 40% ) , fewer rash (73.3%) were important clinical features. Lethargy, somnolence or restlessness (70. 8% ), vomiting (30. 8% ) were early signs of central nervous system ( CNS) ; and the CNS involvement in severe cases was characterized by body trembling or muscle spasm (80% ). High white cell count(75. 8% ) and high blood glucose levels(32. 5% ) were important makers to diagnose the severe HFMD at early stage. There were significant differences in presentation of above features between severe cases and regular cases of HFMD ( P < 0. 01 or P < 0. 05 ) . Early treatment with mannitol, gamma globulin and glucocorticoids were effective, no death was reported and no side effects were found in this case series.