Redondo J, Maseda E, Riquelme A, Alday E, Uña R, Criado A
Servicio de Anestesiología y Reanimación. Hospital General Universitario La Paz. Madrid.
Rev Esp Anestesiol Reanim. 2005 Jun-Jul;52(6):359-62.
An 85-year-old man with a history of moderate chronic obstructive pulmonary disease in treatment with anticholinergic drugs was admitted to the recovery unit for postoperative monitoring after right inguinal herniorrhaphy surgery and removal of a strangulated intestinal section. On the third day after surgery the patient developed radiographic signs consistent with pneumonia and required mechanical ventilation. Two blood cultures and a respiratory secretion sample grew a microorganism identified as Hafnia alvei. H. alvei is a gram-negative bacillus that colonizes the digestive tract of humans and animals and in immunodepressed patients it can colonize the mouth and pharynx. Isolation of H. alvei is described in the literature on pediatric patients and those with a history of immune deficiency or chronic disease. Infection has a severe impact on general health. We report a rare and interesting case of pneumonia and bacteremia from H. alvei infection acquired by an immunocompetent patient soon after arrival in the postoperative recovery unit. The patient died of the infection.
一名85岁男性，有中度慢性阻塞性肺疾病病史，正在接受抗胆碱能药物治疗，因右侧腹股沟疝修补术及切除绞窄性肠段后入住恢复病房进行术后监测。术后第三天，患者出现与肺炎相符的影像学征象，需要机械通气。两次血培养和一份呼吸道分泌物样本培养出一种被鉴定为蜂房哈夫尼亚菌的微生物。蜂房哈夫尼亚菌是一种革兰氏阴性杆菌，可在人和动物的消化道定殖，在免疫功能低下的患者中，它可在口腔和咽部定殖。在有关儿科患者以及有免疫缺陷或慢性疾病病史患者的文献中描述过蜂房哈夫尼亚菌的分离情况。感染对总体健康有严重影响。我们报告了一例罕见且有趣的病例，一名免疫功能正常的患者在术后恢复病房入院后不久即因感染蜂房哈夫尼亚菌而发生肺炎和菌血症。患者死于该感染。
