A 68-year-old woman living in Japan presented to the clinic with a 5-day history of fevers, myalgias(肌痛), and petechial rash(斑丘皮疹) spreading on her arms, trunk, palms, and soles. On exam, there was also an eschar(焦痂) on the right medial ankle. Laboratory studies showed thrombocytopenia(血小板减少症), elevated inflammatory markers, and elevated liver transaminases(转氨酶).
Which of the following is the most appropriate treatment?
A. Antihistamine (抗组胺药)
B. Glucocorticoid (糖皮质激素)
C. Observation
D. Tetracycline (四环素)
E. Valacyclovir(伐昔洛韦)
答案解析:
焦痂活检标本的聚合酶链反应检测检出日本立克次体。诊断为日本斑点热。患者完成2周疗程的米诺环素治疗后,症状消退。
正确答案:D
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