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伴有脓毒性肺栓塞的耐甲氧西林金黄色葡萄球菌败血症

Methicillin-resistant Staphylococcus aureus sepsis presenting with septic pulmonary emboli.

作者信息

Kruse Brian T, Vadeboncoeur Tyler F

机构信息

Department of Emergency Medicine, Mayo Clinic, Jacksonville, Florida, USA.

出版信息

J Emerg Med. 2009 Nov;37(4):383-5. doi: 10.1016/j.jemermed.2007.12.029. Epub 2008 Aug 23.

Abstract

BACKGROUND

Septic pulmonary emboli are the result of infections that typically originate from an extrapulmonary source. Septic pulmonary embolus is a rare disorder that classically presents with fever, respiratory symptoms, and lung infiltrates.

OBJECTIVES

Our objective is to share our experience of a rare diagnosis that was the result of a very common bacterium seen in the Emergency Department (ED).

CASE REPORT

We present a case of methicillin-resistant Staphylococcus aureus (MRSA) sepsis presenting as bilateral septic pulmonary emboli in a patient with undiagnosed acquired immunodeficiency syndrome. A 29-year-old Hispanic man presented to our ED with a history of abdominal pain and vomiting for 3 days and new onset of shortness of breath. The patient was seen 2 weeks prior for a simple abscess incision and drainage and was treated with trimethoprim/sulfamethoxazole. On the day of admission, a helical computed tomography scan of the chest was obtained, which revealed bilateral septic pulmonary emboli. The patient was admitted for intravenous antibiotic therapy and was subsequently found to have MRSA sepsis.

CONCLUSION

Septic pulmonary embolus is a rare finding that is most commonly seen in patients who are immunocompromised. The patient fully recovered after aggressive antibiotic therapy.

摘要

背景

脓毒性肺栓塞是感染的结果,感染通常起源于肺外来源。脓毒性肺栓塞是一种罕见的疾病,典型表现为发热、呼吸道症状和肺部浸润。

目的

我们的目的是分享我们对一种罕见诊断的经验,该诊断是由急诊科常见细菌引起的。

病例报告

我们报告一例耐甲氧西林金黄色葡萄球菌(MRSA)败血症病例,表现为双侧脓毒性肺栓塞,患者患有未确诊的获得性免疫缺陷综合征。一名29岁的西班牙裔男性因腹痛和呕吐3天以及新发呼吸急促就诊于我们的急诊科。该患者2周前因简单脓肿切开引流就诊,并接受了甲氧苄啶/磺胺甲恶唑治疗。入院当天,进行了胸部螺旋计算机断层扫描,显示双侧脓毒性肺栓塞。患者入院接受静脉抗生素治疗,随后被发现患有MRSA败血症。

结论

脓毒性肺栓塞是一种罕见的发现,最常见于免疫功能低下的患者。患者在积极抗生素治疗后完全康复。

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