Nemoto H, Murabayashi K, Kawamura Y, Sasaki K, Wakata N, Kinoshita M, Furube M
Fourth Department of Internal Medicine, Toho University, School of Medicine, Tokyo, Japan.
Intern Med. 1992 Sep;31(9):1125-7. doi: 10.2169/internalmedicine.31.1125.
A 37-year-old male, a poorly-controlled insulin-dependent diabetic patient, was admitted to our hospital with complaints of high fever and confusion. Laboratory data showed hyperglycemia, positive inflammatory reaction and liver dysfunction. Blood culture demonstrated Yersinia enterocolitica. Liver CT scan showed multiple low density areas. These data were consistent with a diagnosis of liver abscess secondary to Yersinia enterocolitica. He died of disseminated intravascular coagulation; subsequent autopsy confirmed the clinical diagnosis. Liver abscess secondary to Yersinia enterocolitica with septicemia is rare, but has been reported in compromised hosts. In the mechanism of this disease, the alimentary tract has been suggested to be the port of entry in most cases.
一名37岁男性,为胰岛素依赖型糖尿病控制不佳患者,因高热和意识模糊入院。实验室检查显示血糖升高、炎症反应阳性及肝功能障碍。血培养显示小肠结肠炎耶尔森菌。肝脏CT扫描显示多个低密度区。这些数据符合小肠结肠炎耶尔森菌继发肝脓肿的诊断。他死于弥散性血管内凝血;随后的尸检证实了临床诊断。小肠结肠炎耶尔森菌继发肝脓肿伴败血症罕见,但在免疫功能低下宿主中已有报道。在这种疾病的发病机制中,大多数情况下提示消化道为感染入口。