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Abstract: The patient, a 27-year-old male, was previously in good health. He developed a high fever 1 week ago, and was treated with self-treatment of Lianhua Qingdian granules and Aminogalamin tablets according to upper respiratory tract infection, but the effect was poor and was accompanied by profuse night sweats and significant fatigue, so he came to our hospital for further examination. The diagnosis of brucellosis combined with liver damage was confirmed. After applying doxycycline hydrochloride tablets + rifampin capsules for antibacterial treatment and silymarin capsules for liver protection, the patient was discharged successfully.
Basic information】Male, 27 years old
Disease Type】Brucellosis combined with liver damage
Hospital】The 988th Hospital of the PLA Joint Security Force
Time of consultation】February 2021
Treatment plan】Medication (doxycycline hydrochloride tablets + rifampin capsules + silymarin capsules)
Treatment period】Inpatient treatment for 10 days, regular follow-up every 1-2 weeks
Treatment effect】Symptoms relieved, all indicators normal, clinical cure
I. Initial consultation
The patient visited the clinic in February 2021 and reported that he had fever for 1 week, and his body temperature dropped after taking antipyretic drugs, but the effect of the drugs passed and he started to have high fever again, sweating a lot at night, feeling weak, and his blood tests showed normal, without complications such as joint pain, hepatosplenomegaly and orchitis. Detailed medical history revealed that the patient was selling vegetables in the vegetable market, and although there was no history of cattle or sheep contact, the next door was a stall selling beef and lamb, and there were brucellosis patients in his precinct. According to his flow and symptoms and medical history, brucellosis was initially considered, and brucellosis antibody test was then prescribed, and the result came back with brucella antibody >1:200, suggesting strong positive, and the clinical preliminary diagnosis was brucellosis, so the patient was admitted to the hospital for treatment.
II. Treatment process
After admission, liver and kidney function, imaging and other related examinations were performed, and chronic febrile diseases such as tuberculosis and endocarditis were ruled out, and brucellosis combined with liver damage was finally diagnosed. After detailed communication with the patient regarding the condition and treatment plan, the patient expressed his willingness to actively cooperate with the treatment. Doxycycline hydrochloride tablets + rifampin capsules were then given as antibacterial treatment, along with hepatoprotective treatment with silymarin capsules.
During this period, the patient paid strict attention to his personal habits, did not consume uncooked beef or mutton, did not drink unsterilized cow or goat milk and other foods, and his diet was mainly high in calories, protein and vitamins, such as chicken, fish, kiwi, etc.
Third, the effect of treatment
After 3 days of antibiotic combination antibacterial treatment, control of hepatocyte inflammation and protection of hepatocyte membrane, the patient’s body temperature returned to normal and his physical symptoms improved; at 10 days of treatment, the patient’s physical strength recovered, he slept normally at night and did not suffer from heavy sweating, his liver function was normal on review, and his mental and psychological state was good. Before discharge, the patient was asked to review liver function every 1-2 weeks to understand the changes in his condition.
IV. Precautions
The patient’s temperature and strength returned to normal after drug treatment, and the discomfort disappeared, so as a doctor, we are truly happy for the patient. After discharge from the hospital, patients should continue to take the above drugs for a period of time as prescribed by the doctor and should not stop or reduce the dosage midway to avoid affecting the recovery. At the same time, patients should maintain a good state of mind and adjust their organism to the best condition, as long as regular and sufficient treatment, most can be completely cured, so there is no need to be too anxious. In addition, patients need to pay attention not to touch raw beef and mutton with bare hands, and take protective measures, such as wearing masks and gloves, if necessary, to ensure their health.
V. Personal insight
Brucellosis is a zoonotic disease, and the common symptom is fever, just like the patient in this case, whose symptoms are recurrent high fever with malaise and sweating. Because the current antibiotics are widely used, most of the fever is irregular, and some patients have osteoarthritis and liver damage, but it also has its own characteristics, other diseases reduce symptoms after the fever subsides, but brucellosis after the fever subsides, but the symptoms are aggravated.