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[急性化脓性甲状腺炎与肺炎克雷伯菌败血症。一例病例报告及文献综述]

[Acute suppurative thyroiditis and Klebsiella pneumoniae sepsis. A case report and review of the literature].

作者信息

Echevarría Villegas M P, Franco Vicario R, Solano López D, Landín Vicuña R, Teira Cobo R, Miguel de la Villa F

机构信息

Servicio de Medicina Interna, Hospital Civil de Bilbao.

出版信息

Rev Clin Esp. 1992 May;190(9):458-9.

PMID:1626091
Abstract

The acute suppurative thyroiditis is a rare infection. It affects specially patients with preexisting thyroid gland pathology and its frequency is higher in women. In childhood it's linked to local anatomic defects. The infection used to be located in left thyroid lobe and it's much less usual in right lobe, in both or in isthmus. The most important causal microorganisms are staphylococci (Staphylococcus aureus overcoat) and streptococci (usually Streptococcus pyogenes and Streptococcus pneumoniae), with frequent isolation of mixed flora and anaerobes in the last reported cases. We present the case of a male patient, without previous thyroid disease, who suffered an acute suppurative thyroiditis and Sepsis due to Klebsiella pneumoniae, with right lobe abscess and secondary septic focus formation (kidneys, spleen, lungs), with fatal course despite of medical treatment, favoured or precipitated by the development of serious alcoholic abstinence.

摘要

急性化脓性甲状腺炎是一种罕见的感染性疾病。它特别容易影响已有甲状腺病变的患者,女性发病率更高。在儿童期,它与局部解剖缺陷有关。感染通常发生在左甲状腺叶,较少见于右叶、双侧或峡部。最重要的致病微生物是葡萄球菌(金黄色葡萄球菌为主)和链球菌(通常为化脓性链球菌和肺炎链球菌),在最近报道的病例中,常分离出混合菌群和厌氧菌。我们报告一例男性患者,既往无甲状腺疾病,因肺炎克雷伯菌感染发生急性化脓性甲状腺炎和脓毒症,伴有右叶脓肿及继发性脓毒症病灶形成(肾脏、脾脏、肺部),尽管接受了治疗,但由于严重戒酒反应的发生,病情恶化或加重,最终导致死亡。

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