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免疫功能正常儿童的肺炎克雷伯菌肝脓肿

Klebsiella pneumoniae liver abscess in an immunocompetent child.

作者信息

Kwon Jang-Mi, Jung Hye Lim, Shim Jae Won, Kim Deok Soo, Shim Jung Yeon, Park Moon Soo

机构信息

Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Korean J Pediatr. 2013 Sep;56(9):407-10. doi: 10.3345/kjp.2013.56.9.407. Epub 2013 Sep 30.

Abstract

Klebsiella pneumoniae has emerged as a leading pathogen that causes pyogenic liver abscesses (PLAs) in Korea. K. pneumoniae liver abscess (KLA) is potentially life threatening, and the diagnosis is difficult. In developed countries, PLA is rarely observed in children and is frequently associated with disorders of granulocyte function and previous abdominal infection. We observed a case of KLA in a healthy 12-year-old boy. To our knowledge, this is the first reported case of KLA in an immunocompetent child without an underlying disease in Korea. The patient was treated with percutaneous catheter drainage and antibiotics. The catheter was placed in the intrahepatic abscess for 3 weeks and parenteral antibiotics (ceftriaxone and amikacin) were administered for 4 weeks, followed by oral antibiotics (cefixime) for 2 weeks. We reported this case to raise awareness of KLA in immunocompetent children among physicians, and to review the diagnosis, risk factors, potential complications, and appropriate treatment of KLA.

摘要

肺炎克雷伯菌已成为韩国引起化脓性肝脓肿(PLA)的主要病原体。肺炎克雷伯菌肝脓肿(KLA)有潜在生命危险,且诊断困难。在发达国家,儿童中很少观察到PLA,且其常与粒细胞功能障碍和既往腹部感染相关。我们观察到一名健康的12岁男孩患KLA的病例。据我们所知,这是韩国首例报道的无基础疾病的免疫功能正常儿童患KLA的病例。该患者接受了经皮导管引流和抗生素治疗。导管置于肝内脓肿3周,静脉注射抗生素(头孢曲松和阿米卡星)4周,随后口服抗生素(头孢克肟)2周。我们报告此病例是为了提高医生对免疫功能正常儿童KLA的认识,并回顾KLA的诊断、危险因素、潜在并发症及适当治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfc2/3819678/05e03130141c/kjped-56-407-g001.jpg

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