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一例导致胎儿死亡和母体弥散性血管内凝血的节杆菌属菌血症。

An Arthrobacter spp. bacteremia leading to fetal death and maternal disseminated intravascular coagulation.

作者信息

Shigeta Naoya, Ozaki Kimiaki, Hori Kensuke, Ito Kimihiko, Nakayama Masahiro, Nakahira Kumiko, Yanagihara Itaru

机构信息

Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Japan.n

出版信息

Fetal Pediatr Pathol. 2013 Feb;31(1):25-31. doi: 10.3109/15513815.2012.659413. Epub 2012 Apr 16.

Abstract

A 34-year-old parous woman developed high fever and threatened preterm labor after a 1-day trip, for which she was receiving prenatal care at a hospital. Three days after onset, at 24 4/7 weeks of gestation, she was transferred to our hospital in an emergency. Soon after the woman's arrival at our hospital, the infant was spontaneously stillborn via a transvaginal delivery. Laboratory tests revealed severe maternal disseminated intravascular coagulation with renal and liver insufficiency. Histopathologic examination of the placenta revealed vast fibrin deposition and remarkable neutrophilic infiltration in the intervillous space, suggesting a rare bacterial infection caused by Arthrobacter spp. The bacteria were predominantly detected in the placenta and maternal blood serum by common bacterial 16S rRNA sequencing after polymerase chain reaction amplification. We report the first case, to our knowledge, of bacteremia with Arthrobacter spp., which may lead to maternal disseminated intravascular coagulation and intrauterine fetal death.

摘要

一名34岁经产妇在进行了为期1天的旅行后出现高热并伴有先兆早产,她正在一家医院接受产前护理。发病3天后,即妊娠24又4/7周时,她被紧急转至我院。该名妇女抵达我院后不久,婴儿经阴道分娩时自然死产。实验室检查显示产妇出现严重的弥散性血管内凝血并伴有肝肾功能不全。胎盘组织病理学检查显示绒毛间隙有大量纤维蛋白沉积和显著的中性粒细胞浸润,提示罕见的节杆菌属细菌感染。聚合酶链反应扩增后,通过普通细菌16S rRNA测序在胎盘和母血清中主要检测到了这些细菌。据我们所知,我们报告了首例节杆菌属菌血症病例,该菌血症可能导致产妇弥散性血管内凝血和宫内胎儿死亡。

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