Saeki Hiroshi, Matsuda Norimasa, Tamura Takashi, Masuda Naoki, Yonei Akitomo
Department of Anesthesiology, Kurashiki Central Hospital, Okayama 710-8622.
Masui. 2002 Feb;51(2):193-5.
Septicemia by Aeromonas hydrophila (A. hydrophila) developed in a 69-year-old female with a history of uncompensated liver cirrhosis. She was admitted to our hospital, complaining of fever, vomiting, diarrhea, and pain as well as swelling of the left lower extremity. Seven hours later, skin of the left extremity developed bullae and became discolored. Although she was treated with infusion of antibiotics plus dopamine, continuous hemodiafiltration, glucose-insulin therapy and mechanical ventilation, she fell in severe septic shock, and died 23 hours after admission. A. hydrophila was isolated from both blood and bullous fluid. Mortality rate of septicemia due to A. hydrophila is reported ranging from 29% to 73%. Patients with liver disease have poor prognosis. Morbidity of this septicemia depends on pre-infection conditions, especially on liver functions. Early surgical debridement and antimicrobial therapy is recommended, but rapid worsening often results in death. We have to pay attention to infection of A. hydrophila especially in patients with liver cirrhosis.
一名69岁、有失代偿期肝硬化病史的女性发生了嗜水气单胞菌败血症。她因发热、呕吐、腹泻、疼痛以及左下肢肿胀而入院。7小时后，左下肢皮肤出现大疱并变色。尽管给予了抗生素加多巴胺输注、持续血液透析滤过、葡萄糖 - 胰岛素治疗及机械通气，但她仍陷入严重感染性休克，入院23小时后死亡。血液和大疱液中均分离出嗜水气单胞菌。据报道，嗜水气单胞菌败血症的死亡率在29%至73%之间。肝病患者预后较差。这种败血症的发病率取决于感染前的状况，尤其是肝功能。建议早期手术清创和抗菌治疗，但病情迅速恶化常导致死亡。我们必须特别关注肝硬化患者中的嗜水气单胞菌感染。
