Albrecht H, Stellbrink H J, Nägele H H, Guthoff A, Greten H
Medizinische Kernklinik und Poliklinik, Universitäts-Krankenhaus Eppendorf, Hamburg.
Dtsch Med Wochenschr. 1991 Mar 1;116(9):331-4. doi: 10.1055/s-2008-1063616.
A 41-year-old man with type II diabetes for the past five years had for three weeks been suffering from high fever (up to 40 degrees), feeling of pressure in the upper abdomen, loss of weight, lack of appetite and increasing weakness. Ultrasound examination as an out-patient was suspicious of diffuse liver metastases from an unknown primary tumour. Ultrasonography and computed tomography after hospitalization suggested multiple liver abscesses. Fine-needle biopsy grew Yersinia enterocolitica. In addition, there was evidence of an asymptomatic intestinal Yersinia infection without septicaemia. After intravenous treatment with three times daily 5 g mezlocillin and three times daily 80 mg tobramycin the fever at first subsided, but the liver abscesses remained unchanged. When fever recurred a week later, cefotaxim, three times daily 2 g, was started. This led to complete regression of the abscesses within three weeks, and the patient has been free of symptoms since.
一名41岁男性,患II型糖尿病已五年,三周来一直高烧(高达40度),上腹部有压迫感,体重减轻,食欲不振且日益虚弱。门诊超声检查怀疑有不明原发肿瘤的弥漫性肝转移。住院后的超声检查和计算机断层扫描提示多发性肝脓肿。细针活检培养出小肠结肠炎耶尔森菌。此外,有证据表明存在无症状的肠道耶尔森菌感染但无败血症。静脉注射每日三次5克美洛西林和每日三次80毫克妥布霉素后,起初发热消退,但肝脓肿未变。一周后发热复发时,开始每日三次静脉注射2克头孢噻肟。这导致脓肿在三周内完全消退,此后患者一直无症状。