Knebel U, Sloot N, Eikenberg M, Borsdorf H, Höffler U, Riemann J F
Medizinische Klinik C, Klinikum der Stadt Ludwigshafen am Rhein.
Med Klin (Munich). 2001 Feb 15;96(2):109-13. doi: 10.1007/pl00002177.
Plesiomonas shigelloides is a common pathogen in tropical regions, whereas it is rarely isolated in temperate climates. It is most often found in surface water and fish. During the last 10 years it was found to cause gastroenteritis 6 times in Ludwigshafen. Not all of these patients reported a trip to foreign countries.
A 54-year-old male patient was hospitalized after a trip to Malaysia with strong greenish watery diarrhea and chills. On physical examination we saw a dehydrated patient in severely reduced general condition. The stool frequency was 30/d. The laboratory examinations only showed elevated parameters of inflammation. Plesiomonas shigelloides was cultivated in the stool cultures. With appropriate substitution of fluid and electrolytes, and antidiarrheal therapy the patient resumed a normal diet without any complications. Three days later his bowel movements were normal and his general condition was greatly improved. We withheld antibiotic therapy because of the noncomplicated course of illness.
In Germany infections with Plesiomonas shigelloides are rare, an increase is observed because of increasing tourism to tropical regions. The course of infection is sometimes asymptomatic, but usually patients develop an acute gastroenteritis. Especially immunocompromised patients can show serious courses of infection. Plesiomonas shigelloides should be included in the differential diagnosis of acute gastroenteritis after journeys to tropical regions. Some of our patients, however, denied traveling to tropical regions. They also denied consuming seafood, which indicates a risk of infection in Germany. Still an infection with Plesiomonas shigelloides seems to be rare in northern European countries.
类志贺邻单胞菌是热带地区的常见病原体，而在温带气候中很少分离到。它最常见于地表水和鱼类中。在过去10年里，路德维希港有6次发现该菌导致胃肠炎。并非所有这些患者都报告去过国外。
一名54岁男性患者在前往马来西亚旅行后，因剧烈的绿色水样腹泻和寒战入院。体格检查发现患者脱水，全身状况严重不佳。大便频率为每天30次。实验室检查仅显示炎症指标升高。粪便培养中培养出了类志贺邻单胞菌。通过适当补充液体和电解质以及止泻治疗，患者恢复了正常饮食，没有出现任何并发症。三天后，他的排便正常，全身状况大为改善。由于病情未出现并发症，我们未给予抗生素治疗。
在德国，类志贺邻单胞菌感染很少见，由于前往热带地区旅游的人数增加，感染病例有所上升。感染过程有时无症状，但患者通常会患上急性胃肠炎。尤其是免疫功能低下的患者可能会出现严重的感染病程。对于前往热带地区旅行后出现急性胃肠炎的患者，应将类志贺邻单胞菌纳入鉴别诊断。然而，我们的一些患者否认去过热带地区。他们也否认食用过海鲜，这表明德国存在感染风险。不过，在北欧国家，类志贺邻单胞菌感染似乎仍然很少见。
