Hội chứng thực bào máu liên quan đến Trypanosoma evansi: một trường hợp hiếm gặp

Hpi CHUfNG THI/C BAO MAU LIEN QUAN DEN

TRYPANOSOMA EVANSh MOT TRlTCING H0P HIEM GAP

Le Bmi Chau\ Nguyin Van Vinh Chau^

Muc tieu: Nghien cixu truang hgp nhiem Trypanosoma evansi a nguoi voi cac bieu hien cua

hpi chung thuc bao mau. Doi tuang vd phucmg phdp: Mo ta 1 truang hop benh nhan nil 38 tuoi,

CO den Dac Lac truoc khi khoi benh, dugc ch4n doan xac dinh nhilm Levansi bang ky thuat

PCR, chan doan hoi chung thuc bao mau theo tieu chu4n cua hgi thuc bao nam 2004, dugc dieu

tri va theo doi tai benh vien Benh Nhiet dai vao thang 03/2015. Kit qud: Lam sang biSu hien

sot keo dai, thieu mau, suy da ca quan. Ngoai cac xet nghiem thoa tieu chuan chin doan hgi

chung thuc bao mau (HLH - 2004), con c6 vang da, giam albumin mau, giam natri mau. Mat

dp ky sinh tning trong mau luc nhap vien rat cao. Benh cai thien nhanh chong vai Suramine va

dieu chinh roi loan chuc nang cua cac ca quan. Ket lugn: Nhi6m Levansi a nguai hiem gap

nhung CO the bieu hien nang, de nham lan vai cac benh ly khac. Benh hoi phuc hoan toan voi

dieu tri dac hieu kem ho trg.

Tu" khoa: Hgi chiing thuc bao mau, Trypanosoma evansi.

MO DAU

Trypanosoma sp la ky smh trung ddn bao (protozoan)

cd the gay benh cho ngu'di, vat nudi va dong vat hoang

dai. Cd 2 loai Trypanosoma chinh gay benh cho ngu'di la

Trypanosoma brucei gambiense hoacT.brucei rhodesiense

lay truyen do ruoi tsetse, gay benh ngu d chau Phi va Try￾panosoma cruzi lay truyen do loai bp xit, gay benh Cha￾gas d chau My, dac biet d Nam My. Ngoai ra cdn cd nhCihg

loai Trypanosoma khac phan bo d nhieu ndi tren the gidi,

gay benh chu yeu d dong vat nhUTevansi, Tcongolense,

T.gambiense, T. vivax va T.siminae. Cac loai Trypanosoma

gay benh d dong vat rat hiem khi gay benh d ngu'di vi cd

the ngu'di cd yeu to bao ve tii nhien chong lai sU lay nhiem

Trypanosoma. Tuy vay, trong Y van cung ghi nhan mpt so

loai cd the gay benh cho ngu'di nhu" T.brucei brucei,

T.vivax, Tcongolense, T.evansi, T.lewisi, va T.lewisi - \\ke^.

'"Bo mon ThvvPrt nhiem, Dai hQC Y - Buac thanh phd Ho Chi Minh;

'-'B$nh v\4n B^nh nhi^tdai thanh pho Ho Chi Minh

Ngiy nh§n bai: 06/7/2015.

Ngiy phan bifn xong: 15/7/2015

Ngay duyf I «4ng: 3r/7/20!5

Ngu*i chju trach nhifm ngi dung khoa hpc: Li Bin Chdu, Bg mon

Truyen nhiem. flpi hoc Y - Du^rc thdnh pho Ho Chi Mmh.

Di^nlhoQi 09I8II5600; E-mail buuchaule@yahoo com

Chung tdi bao cao tru'dng hdp xac dinh nhiem Try￾panosoma evansi dau tien d ngu'di tai Viet Nam vdi bieu

hien hdi chu'ng thu'c bao mau™, nham ddng gdp kinh

nghiem chan doan va dieu tri benh ly hiem gap nay.

DOI TU'ONG VAT LIEU VA PHU'aNG PHAP

Md ta 01 tru'dng hdp nhilm Tevansi dieu tri tai Benh

vien Benh nhiet ddi thanh phd Ho Chf Minh (BV BNO TP

HCM) vao thang 03/2015. Xet nghiem phet mau ngoai

bien soi tim, dem mat do ky smh trung va cac xet nghiem

smh hda, huyet hpc du'dc thu'c hien tai Khoa Xet nghiem

BV BND TP HCM. Mat dp ky smh trung trong mau dUdc

theo doi moi 12 gid cho den khi ket qua am tinh, sau dd

theo doi moi ngay cho den khi ra vien. Rieng xet nghiem

huyet thanh chan doan va PCR (polymerase chain reac￾tion) dinh danh tac nhan gay benh du'dc thi/c hien tai

Phdng Ky sinh trung, Khoa Thu y, Oai hpc Kasetsart, Thai

Lan. Huyet thanh chan doan sir dung phu'dng phap

CAHIT.evansI, nguhg ket tri/c tiep giiJa khang nguyen va

khang the tren ban nhi/a (Card Agglutination Test for Try￾panosomiasis). PCR dinh danh ky sinh trung du'dc thu'c

hien nhu" sau:

- PCR sCr dung cap moi dac hieu cho Trypanozoon

Typl (Desquesnes et al, 2002), TBR (Moser et al., 1989).

TRUYiNNHliwIVllTNAM^SO 3(11)-2015-51