Wong S N, Tam A Y, Yung R W, Kwan E Y, Tsoi N N
Department of Paediatrics, Queen Mary Hospital, Hong Kong.
Acta Paediatr Scand. 1991 May;80(5):515-20. doi: 10.1111/j.1651-2227.1991.tb11895.x.
Among 27 cases of Pseudomonas septicaemia in the Department of Paediatrics of Queen Mary Hospital from 1981 to 1988, we have identified 10 children without known predisposing causes before presentation and report their clinical features. Six were infants, of whom 4 developed shock on admission and died. Ecthyma gangrenosum was present in 4 patients. Pseudomonas aeruginosa was isolated in 8 patients. All isolates, except Ps. cepacia, were sensitive to gentamicin. One patient had cyclical neutropenia. Another had an appendicular abscess. Salmonella was cultured from the stool in one patient. Although Pseudomonas septicaemia is normally considered to be associated with underlying immunodeficiency, in 22% it occurred in previously healthy children. Mortality is high especially in infants who develop septicaemic shock. It is advisable to cover for Pseudomonas septicaemia with aminoglycosides or ceftazidime in sick septic infants.
1981年至1988年期间，在玛丽医院儿科的27例假单胞菌败血症病例中，我们发现有10名儿童在发病前无已知的诱发因素，并报告了他们的临床特征。6名是婴儿，其中4名入院时发生休克并死亡。4例患者出现坏疽性脓皮病。8例患者分离出铜绿假单胞菌。除洋葱伯克霍尔德菌外，所有分离株对庆大霉素敏感。1例患者有周期性中性粒细胞减少症。另1例有阑尾脓肿。1例患者粪便中培养出沙门氏菌。虽然假单胞菌败血症通常被认为与潜在的免疫缺陷有关，但22%发生在先前健康的儿童中。死亡率很高，尤其是发生败血症休克的婴儿。对于患病的败血症婴儿，建议用氨基糖苷类药物或头孢他啶覆盖治疗假单胞菌败血症。
