PMC10072143_01
The patient's laboratory dynamic monitoring indicators. (A) The dynamic monitoring of the level of PLT and CRP (PLT normal range, 125x109-350x109/L; CRP normal range, 0.00-5.00 mg/L); (B) The dynamic monitoring of the level of ALT and AST (ALT normal range, 9-50 U/L; AST normal range, 15-40 U/L); (C) The dynamic monitoring of the level of TBiL and DBiL (TBil normal range, 0.0-26.0 mumol/L; DBil normal range, 0.0-8.0 mumol/L).
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The results of laboratory tests were as follows (Figure 1): total white blood cell count, 5.00x109/L (normal range, 3.50 x 109-9.50x109/L); neutrophil count, 3.90x109/L (normal range, 1.80 x 109-6.30x109/L); hemoglobin, 149 g/L (normal range, 130-175 g/L); platelet count, 71x109/L (normal range, 125 x 109-350x109/L); C-reactive protein, 93.15 mg/L (normal range, 0.00-5.00 mg/L); Procalcitonin 2.13 ng/mL (normal range, 0.00-0.50 ng/mL); total protein, 63.5 g/L (normal range, 65.0-85.0 g/L); alanine aminotransferase, 167 U/L (normal range, 9-50 U/L); aspartate aminotransferase, 143 U/L (normal range, 15-40 U/L); total bilirubin, 28.9mumol/L (normal range, 0.0-26.0 mumol/L); direct bilirubin, 19.0 mumol/L (normal range, 0.0-8.0 mumol/L); fibrinogen content, 4.53g/L (normal range, 2.00-4.00 g/L); and D-dimer content, 1.75 ug/mL (normal range, 0.00-0.50 ug/mL).
Longitudinal analysis of temperature change and therapeutic drug. After using specific drugs:tetracycline, the temperature was under control.
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On April 30, tetracycline (250mg, q6h) was added empirically to the original treatment for anti-tick infection (Figure 2).
The results of metagenomic next-generation sequencing in blood. "Mapping sequence number" means that the number of reads can be uniquely mapped to the genome of Coxiella burnetii, but cannot be mapped to other species. The 79 reads covered 0.20% of C. burnetii genome. The "relative abundance" reflected the relative proportion of genomes in the corresponding classification of the pathogen.
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Coxiella burnetii (mapping sequence number 79, relative abundance 15.96%) (Figure 3). Combining the patient's history of insect bites, occupation, symptoms and signs, and auxiliary examination results, the patient was diagnosed with acute Q fever infection with pneumonia. 