Kumagai Jin, Takiguchi Yasuo, Shono Katsuhiro, Suruga Yosuke, Akiba Yoko, Yamamoto Kyohei, Terano Takashi
Department of Internal Medicine, Chiba Aoba Municipal Hospital, Japan.
Intern Med. 2013;52(22):2573-6. doi: 10.2169/internalmedicine.52.9580.
A 74-year-old woman visited an otolaryngology clinic with pharyngeal pain, and was diagnosed with a peritonsillar abscess. She received antibiotics and underwent incisional drainage, but displayed high white blood cell and blast cell counts, and was referred to our hospital. Gram-negative rods (Leptotrichia trevisanii) were detected in blood cultures performed on admission. She was diagnosed with bacteremia and acute myelogenous leukemia (FAB classification: M1). After antibiotic therapy, she temporarily recovered from the bacteremia, but subsequently died on day 34. Although Leptotrichia trevisanii bacteremia is extremely rare, clinicians should consider it in cases involving immunocompromised patients with oral lesions.
一名74岁女性因咽痛前往耳鼻喉科诊所就诊，被诊断为扁桃体周围脓肿。她接受了抗生素治疗并进行了切开引流，但白细胞和原始细胞计数仍很高，随后被转诊至我院。入院时血培养检测到革兰氏阴性杆菌（曲氏纤毛菌）。她被诊断为菌血症和急性髓系白血病（FAB分类：M1）。抗生素治疗后，她的菌血症暂时得到缓解，但随后在第34天死亡。尽管曲氏纤毛菌菌血症极为罕见，但临床医生在处理有口腔病变的免疫功能低下患者时应考虑到这种情况。
