Ayelo Navarro A, Gerónimo Pardo M, Torres Lamberti V, Mateo Cerdán C M, Jiménez Vizuete J M, Peyro García R
Sección de Anestesia y Reanimación, Hospital General de Almansa, Almansa, Albacete, España.
Rev Esp Anestesiol Reanim. 2013 Feb;60(2):103-5. doi: 10.1016/j.redar.2012.04.005. Epub 2012 May 30.
The case is presented of a 38 year-old patient who was admitted in the Emergency Department due to a severe acute respiratory failure and who was transferred to the Critical Care Unit with a suspected initial diagnosis of community acquired pneumonia caused by an atypical microorganism, which was complicated with an acute respiratory distress syndrome. This was able to be treated with non-invasive mechanical ventilation. At 48 hours after admission, the growth of Gram negative bacilli in the blood culture was reported, which was subsequently identified as Salmonella enteritidis. This information, along with the lymphopenia suffered by the patient, suggested an immunodepressed state, thus serological tests were performed which showed positive for HIV. Antibiotic treatment was started based on the microbiological findings, with a favourable clinical outcome for the patient.
本文介绍了一名38岁患者的病例，该患者因严重急性呼吸衰竭入住急诊科，并被转入重症监护病房，初步怀疑诊断为非典型微生物引起的社区获得性肺炎，并发急性呼吸窘迫综合征。该患者接受了无创机械通气治疗。入院48小时后，血培养报告革兰氏阴性杆菌生长，随后鉴定为肠炎沙门氏菌。这一信息以及患者出现的淋巴细胞减少表明其处于免疫抑制状态，因此进行了血清学检测，结果显示HIV呈阳性。根据微生物学检查结果开始使用抗生素治疗，患者临床预后良好。
