Won Dahae, An Dongheui, Kim Mi-Na, Lee Young Sang
Department of Laboratory Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Korean J Lab Med. 2011 Apr;31(2):118-21. doi: 10.3343/kjlm.2011.31.2.118.
A 42-yr-old man with hepatitis B virus associated liver cirrhosis was admitted to the emergency room because of multiple seizures, a history of chills and myalgia over the previous 2 weeks, and 3 days of melena. He was febrile with a temperature of 38.0°C. There were no symptoms and signs related to the genitourinary system, skin, or joints. Three sets of blood cultures were obtained and oxidase-positive, gram-negative diplococci were detected after 25.9-26.9 hr of incubation in all aerobic vials. The organism was positive for catalase and oxidase, and was identified as Neisseria gonorrhoeae, using a Vitek Neisseria-Haemophilus Identification card (bioMérieux Vitek, Inc., USA). Further, 16S rRNA sequencing of this isolate revealed a 99.9% homology with the published sequence of N. gonorrhoeae strain NCTC 83785 (GenBank Accession No. NR_026079.1). Acute bleeding by variceal rupture seems to be a likely route of introduction of N. gonorrhoeae from the mucosa into the blood. To the best of our knowledge, this is the first case of gonococcal bacteremia in Korea.
一名42岁的乙型肝炎病毒相关性肝硬化男性因多次癫痫发作、过去2周有寒战和肌痛病史以及3天的黑便而被收入急诊室。他发热，体温为38.0°C。没有与泌尿生殖系统、皮肤或关节相关的症状和体征。采集了三组血培养物，在所有需氧瓶中孵育25.9 - 26.9小时后检测到氧化酶阳性的革兰氏阴性双球菌。该菌过氧化氢酶和氧化酶呈阳性，使用Vitek奈瑟菌 - 嗜血杆菌鉴定卡（美国bioMérieux Vitek公司）鉴定为淋病奈瑟菌。此外，该分离株的16S rRNA测序显示与已发表的淋病奈瑟菌菌株NCTC 83785（GenBank登录号NR_026079.1）序列有99.9%的同源性。静脉曲张破裂引起的急性出血似乎是淋病奈瑟菌从黏膜进入血液的可能途径。据我们所知，这是韩国首例淋菌性菌血症病例。
