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肺炎克雷伯菌引起的化脓性肝脓肿

[Pyogenic liver abscess caused by Klebsiella pneumoniae].

作者信息

Zoricić Ivan, Vukusić Darko, Sever Marko, Lojo Nermin, Barić Marko

机构信息

Klinicka bolnica Sveti Duh, Klinika za kirurgiju, Zagreb, Hrvatska.

出版信息

Acta Med Croatica. 2012 Oct;66(4):321-5.

Abstract

Pyogenic liver abscess caused by Klebsiella pneumoniae is usually found in Southeast Asia, while in Europe Escherichia coli, Streptococcus or Staphylococcus are most common. In case of a failed ultrasound controlled abscess, aspiration surgical treatment is indicated. This paper reports the clinical case of pyogenic liver abscess caused by Klebsiella pneumoniae, which was treated by operative drainage. A 60-year-old patient was transferred to our institution from the University Hospital for Infectious Diseases with septic temperature, abdominal pain and finding of Klebsiella pneumoniae liver abscess (resistant to antibiotic therapy). Additional laboratory tests and abdominal MSCT scan confirmed the initial diagnosis. The localization of abscesses technically prevented ultrasound-controlled abscess aspiration and drainage; after appropriate preparation, operative liver abscess incision and drainage were performed. Microbiological examination of the abscess sample revealed Klebsiella pneumoniae as the cause of liver abscess.

摘要

由肺炎克雷伯菌引起的化脓性肝脓肿通常在东南亚地区较为常见,而在欧洲,大肠杆菌、链球菌或葡萄球菌最为常见。对于超声引导下脓肿穿刺失败的情况,需进行手术治疗。本文报告了一例由肺炎克雷伯菌引起的化脓性肝脓肿经手术引流治疗的临床病例。一名60岁患者因感染性发热、腹痛并被发现患有肺炎克雷伯菌肝脓肿(对抗生素治疗耐药),从传染病大学医院转至我院。进一步的实验室检查和腹部MSCT扫描证实了初步诊断。脓肿的位置从技术上无法进行超声引导下的脓肿穿刺引流;经过适当准备后,进行了手术切开肝脓肿引流。脓肿样本的微生物学检查显示肺炎克雷伯菌是肝脓肿的病因。

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