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沙门氏菌肠炎亚种明尼苏达菌引起的尿路败血症,患者患有克罗恩病,但近期或当前无胃肠道症状。

Salmonella enterica serovar Minnesota urosepsis in a patient with Crohn's disease in the absence of recent or current gastrointestinal symptoms.

机构信息

Department of Gastroenterology, Intoxications and Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.

Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany.

出版信息

J Med Microbiol. 2013 Sep;62(Pt 9):1360-1362. doi: 10.1099/jmm.0.059352-0. Epub 2013 Jun 20.

Abstract

Salmonella enterica serovar Minnesota is a rarely isolated organism in clinical samples mainly grown from stool cultures. Sepsis due to Salmonella is known in severely immunocompromised patients, but so far urosepsis due to S. enterica serovar Minnesota has not been described. We report a case of a 31-year-old patient suffering from Crohn's disease treated with infliximab and azathioprine, in whom was implanted a double-J ureteric catheter for urolithiasis. The patient presented with urinary tract infection and severe sepsis. S. enterica serovar Minnesota was grown from urine and blood cultures. After empiric antimicrobial treatment with meropenem and vancomycin, treatment was changed to ceftriaxone. Antimicrobial treatment was continued for a total of 3 weeks without evidence of Salmonella recurrence on follow-up visits. Salmonella spp. rarely cause urinary tract infection and sepsis. However, in immunocompromised patients, non-typhoidal salmonellosis merits a thorough clinical and microbiological evaluation.

摘要

明尼苏达沙门氏菌血清型是一种在临床样本中很少分离到的生物体,主要从粪便培养物中培养出来。严重免疫功能低下的患者会因沙门氏菌引起败血症,但迄今为止,尚未有明尼苏达沙门氏菌血清型引起的尿路感染性败血症的报道。我们报告了一例患有克罗恩病的 31 岁患者,该患者接受英夫利昔单抗和硫唑嘌呤治疗,并植入了双 J 输尿管导管以治疗尿路结石。该患者出现尿路感染和严重败血症。从尿液和血液培养物中培养出明尼苏达沙门氏菌血清型。在使用美罗培南和万古霉素进行经验性抗菌治疗后,改为头孢曲松治疗。抗菌治疗共持续 3 周,随访时未见沙门氏菌复发的证据。沙门氏菌很少引起尿路感染和败血症。然而,在免疫功能低下的患者中,非伤寒性沙门氏菌病需要进行彻底的临床和微生物学评估。

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