Schneider F, Lang N, Reibke R, Michaely H J, Hiddemann W, Ostermann H
Department of Internal Medicine III, Ludwig-Maximilians University, Campus Grosshadern, Marchioninistrasse 15, 81377 München, Germany.
Med Mal Infect. 2009 Jun;39(6):397-400. doi: 10.1016/j.medmal.2008.11.010. Epub 2009 Jan 23.
Plesiomonas shigelloides is known to cause mild to cholera-like diarrhea in most infected persons. In immunocompromised patients extra-intestinal manifestations have been described. We report the first case of pneumonia caused by P. shigelloides in a 76-year-old woman who had undergone a curative gastrectomy and esophageal-jejunostomy due to a low differentiated adenocarcinoma of the stomach (pT2, pN1 pMx, G3, R0, Lauren: intestinal type). The patient was admitted in hospital with clinical signs of pulmonary infection. CT-scan revealed a cavernous lesion in the right upper pulmonary lobe. Bronchial lavage showed a granulocytic inflammation 105CFU/ml P. shigelloides. Although antibiotic treatment led to a decrease of inflammation parameters and decrease of the pulmonary infiltrate the patient died due to development of torsades de pointes tachycardia leading to ventricular fibrillation and hypoxic brain damage.
嗜水气单胞菌已知会在大多数感染者中引起轻度至霍乱样腹泻。在免疫功能低下的患者中,已有肠道外表现的描述。我们报告了首例由嗜水气单胞菌引起的肺炎病例,患者为一名76岁女性,因胃低分化腺癌(pT2,pN1 pMx,G3,R0,Lauren:肠型)接受了根治性胃切除术和食管空肠吻合术。患者因肺部感染的临床症状入院。CT扫描显示右上肺叶有一个海绵状病变。支气管灌洗显示有粒细胞炎症,嗜水气单胞菌为105CFU/ml。尽管抗生素治疗导致炎症参数下降和肺部浸润减少,但患者因尖端扭转型室性心动过速发展为心室颤动和缺氧性脑损伤而死亡。