Fuchs K F, Kopischke S, Grimmer U, Hrdlicka P
Klinik für Innere Medizin und Rheumatologie, Klinikum Bethanien Chemnitz gGmbH.
Internist (Berl). 2004 Jan;45(1):85-9. doi: 10.1007/s00108-003-1100-8.
We present a case of an 81-year-old diabetic man with anaerobic sepsis due to acalculous cholecystitis. The patient was admitted to our hospital with a seven-day history of severe abdominal pain accompanied with fever and somnolence. Blood cultures taken during the initial procedure developed Clostridium perfringens. The patient was immediately treated with parenteral penicillin. The ultrasonography pointed out the case: the gall bladder was found to be distended and slightly thickened. This result was interpreted as an acute non-emphysematous cholecystitis. The material obtained by needle aspiration and therapeutical emptying of the gall bladder revealed large gram positive rods, that also proved to be Clostridium perfringens. The patients course afterwards was uneventful. Antibiotics were continued and he was discharged after 13 days in a stable condition.
我们报告一例81岁糖尿病男性因非结石性胆囊炎导致厌氧性败血症的病例。患者因严重腹痛伴发热和嗜睡7天入院。初始检查时采集的血培养发现产气荚膜梭菌。患者立即接受胃肠外青霉素治疗。超声检查明确了病情:发现胆囊扩张且轻度增厚。这一结果被解释为急性非气肿性胆囊炎。通过胆囊穿刺抽吸和治疗性排空获得的物质显示有大量革兰氏阳性杆菌,也证实为产气荚膜梭菌。患者随后病情平稳。继续使用抗生素治疗,13天后患者病情稳定出院。