由胆总管结石引起的无胆囊结石的产气荚膜梭菌菌血症。
Clostridium perfringens bacteremia caused by choledocholithiasis in the absence of gallbladder stones.
机构信息
Department of Gastroenterology, James H Quillen V.A. Medical Center, Johnson, Mountain Home, TN 37615, United States.
出版信息
World J Gastroenterol. 2012 Oct 21;18(39):5632-4. doi: 10.3748/wjg.v18.i39.5632.
Abstract
A 67-years-old male presented with periumbilical abdominal pain, fever and jaundice. His anaerobic blood culture was positive for clostridium perfringens. Computed tomogram scan of the abdomen and abdominal ultrasound showed normal gallbladder and common bile duct (CBD). Subsequently magnetic resonance cholangiopancreaticogram showed choledocholithiasis. Endoscopic retrograde cholangiopancreaticogramwith sphincterotomy and CBD stone extraction was performed. The patient progressively improved with antibiotic therapy Choledocholithiasis should be considered as a source of clostridium perfringens bacteremia especially in the setting of elevated liver enzymes with cholestatic pattern.
摘要
一位 67 岁男性因脐周腹痛、发热和黄疸就诊。其厌氧血液培养为产气荚膜梭菌阳性。腹部 CT 扫描和腹部超声显示胆囊和胆总管正常。随后磁共振胰胆管成像显示胆总管结石。行内镜逆行胰胆管造影术并括约肌切开和胆总管取石术。患者经抗生素治疗后逐渐好转。应考虑胆总管结石为产气荚膜梭菌菌血症的来源，尤其是在伴有胆汁淤积模式的肝酶升高的情况下。
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