Kawsar Hameem I, Gopal K V, Shahnewaz Jamila, Daw Hamed A
Department of Medicine, Fairview Hospital, Cleveland, Ohio, USA.
BMJ Case Rep. 2012 Jul 3;2012:bcr0220125938. doi: 10.1136/bcr.02.2012.5938.
A patient presented to our hospital with worsening shortness of breath, cough and respiratory distress that slowly worsened over 7-10 days. She had a viral-like illness with runny nose and cough for 1 week, which became productive of yellowish sputum. She was treated with antibiotic and steroid with clinical improvement. Her leucocyte count continued to increase despite discontinuation of both antibiotic and steroid. All culture results returned negative. She did not have any abdominal pain or diarrhoea. Her stool was positive for Clostridium difficile toxin assayed by PCR. A CT of abdomen showed distension of cecum and proximal colon. She was treated with intravenous metronidazole, oral and rectal vancomycin and intravenous immunoglobulin. She developed multi-organ failure and died.
一名患者因呼吸急促、咳嗽和呼吸窘迫症状加重前来我院就诊，这些症状在7至10天内逐渐恶化。她有类似病毒感染的疾病，流鼻涕和咳嗽1周，之后咳出黄色痰液。她接受了抗生素和类固醇治疗，临床症状有所改善。尽管停用了抗生素和类固醇，她的白细胞计数仍持续升高。所有培养结果均为阴性。她没有腹痛或腹泻。通过聚合酶链反应检测，她的粪便艰难梭菌毒素呈阳性。腹部CT显示盲肠和近端结肠扩张。她接受了静脉注射甲硝唑、口服和直肠用万古霉素以及静脉注射免疫球蛋白治疗。她出现多器官功能衰竭并死亡。
