Stoner M C, Forsythe R, Mills A S, Ivatury R R, Broderick T J
Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0519, USA.
Am Surg. 2000 Feb;66(2):219-22.
The case of a young woman presenting with fever, abdominal distention, and diarrhea is presented. While hospitalized, she developed peritonitis, and a laparotomy was performed emergently. Intraoperative and pathologic examinations are highly suggestive of Salmonella typhi as an etiology for her symptoms and eventual perforation. Salmonella enteritis can be a difficult diagnosis to make, but in most cases it is a self-limited disease process. In a minority of cases, multidrug antibiotic therapy may be required secondary to an increasing prevalence of resistant strains. Patients who perforate require prompt operation to limit morbidity and mortality. Outcome is significantly improved in those patients by directed resection of the affected segment of bowel and by aggressive perioperative care.
本文介绍了一名出现发热、腹胀和腹泻症状的年轻女性病例。住院期间，她发展为腹膜炎，并紧急进行了剖腹手术。术中及病理检查强烈提示伤寒沙门氏菌是其症状及最终穿孔的病因。肠炎沙门氏菌感染可能难以诊断，但在大多数情况下是一种自限性疾病过程。在少数情况下，由于耐药菌株的日益流行，可能需要多药联合抗生素治疗。发生穿孔的患者需要立即手术以降低发病率和死亡率。通过对受影响肠段进行定向切除以及积极的围手术期护理，这些患者的预后可得到显著改善。
